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| Home > Publications database > Histologic Ex Vivo Validation of the [18F]SITATE Somatostatin Receptor PET Tracer. |
| Journal Article | DKFZ-2025-01062 |
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2025
Soc.
New York, NY
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Please use a persistent id in citations: doi:10.2967/jnumed.125.269619
Abstract: Radiolabeled somatostatin analogs (SSAs), such as [68Ga]Ga-DOTA SSAs, have transformed imaging and therapeutic strategies. However, their use is constrained by the high cost of generators and their short half-life. In contrast, [18F]SITATE presents a promising alternative, offering the advantage of a longer half-life than 68Ga, along with the cost-effectiveness of cyclotron-based production. This study evaluated the first histologic ex vivo validation of [18F]SITATE. Methods: This study retrospectively included 47 patients (57% male; mean age, 66.9 ± 14.9 y) with histologically confirmed well-differentiated neuroendocrine neoplasms who underwent [18F]SITATE PET followed by surgery within 4 mo. Lesion uptake was quantified using SUVmean, SUVpeak, SUVmax, and tumor-to-liver ratio (TLR). Histologic somatostatin receptor (SSTR) type 2 expression was determined using histological scores (H-scores), with thresholds defining SSTR scores 1-3. The accuracy of PET imaging for preoperative metastatic detection was evaluated against surgical histology. Results: PET imaging demonstrated a significant correlation between [18F]SITATE uptake (SUVmean and TLR) and SSTR type 2 H-scores (r = 0.618 and 0.622, respectively; P < 0.0001). SSTR score 3 correlated with increased SUVmean and TLR (P < 0.0001). Among 35 patients with primary resection and lymphadenectomy, PET achieved a sensitivity of 73.9% and specificity of 100%. Conclusion: [18F]SITATE PET imaging strongly correlates with histologic SSTR expression, demonstrating utility in staging and guiding therapeutic decisions in neuroendocrine neoplasms. This 18F-labeled tracer shows specificity comparable to historical [68Ga]Ga-DOTA SSA data, whereas an increase in sensitivity for the detection of locoregional metastases appears possible. Further head-to-head comparisons of [18F]SITATE with traditional [68Ga]Ga-DOTA SSA and histologic validation are warranted to optimize its diagnostic accuracy and clinical impact.
Keyword(s): PET ; SSTR PET ; [18F]SITATE ; neuroendocrine neoplasms ; oncology ; radiotracer tissue kinetics
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