EJNMMI reports · 2025
Comparison of inter- and intraobserver agreement between [18F]AlF-NOTA-octreotide and [68Ga]Ga-DOTA-SSA PET/CT.
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Leupe Hannes, Ahmadi Bidakhvidi Niloefar, Goffin Karolien, Van den Broeck Bliede, Jentjens Sander, Laenen Annouschka, Pauwels Elin, Lybaert Willem, Van Cutsem Eric, Bormans Guy, Vandamme Timon, Cleeren Frederik, Dekervel Jeroen, Geboes Karen, Stroobants Sigrid, Verslype Chris, Deroose Christophe M
Аннотация
PURPOSE: This study compares inter- and intraobserver agreement between [18F]AlF-NOTA-octreotide ([18F]AlF-OC) and [68Ga]Ga-DOTA-somatostatin analogues (SSAs) in PET/CT imaging for neuroendocrine neoplasm (NEN) patients.
MATERIALS AND METHODS: This is a secondary endpoint analysis from our multicenter trial (clin trial.gov identifier: NCT04552847) including 75 NEN patients who received both [68Ga]Ga-DOTATATE (n = 56) or [68Ga]Ga-DOTA-NOC (n = 19) and [18F]AlF-OC PET imaging. Five readers assessed lesion detection and characterization across multiple organs, scoring lesions by number and conspicuity using a 5-point Likert scale. Agreement was measured using Gwet's agreement coefficient.
RESULTS: Results demonstrated nearly perfect interobserver agreement for lesion characterization across all organs for both tracers (0.921 for [18F]AlF-OC; 0.934 for [68Ga]Ga-DOTA-SSA). Similar agreement was observed for the number of lesions across organs (0.736 for [18F]AlF-OC and 0.749 for [68Ga]Ga-DOTA-SSAs). Organ-specific analysis revealed strong agreement for bone and liver lesions, with slightly lower agreement for lymph nodes. Both tracers also showed excellent agreement in determining Krenning scores (0.925 for [18F]AlF-OC and 0.927 for [68Ga]Ga-DOTA-SSAs). While mean lesion conspicuity was similar between tracers, [18F]AlF-OC had a higher global image quality score (4.22 vs. 3.86, p < 0.0001). Intraobserver agreement was consistent between tracers for lesion characterization (> 0.95 for both readers) and lesion count (> 0.80 for both readers).
CONCLUSION: [18F]AlF-OC and [68Ga]Ga-DOTA-SSAs demonstrate comparable and excellent inter- and intraobserver agreement, reinforcing the clinical interchangeability of [18F]AlF-OC PET/CT with [68Ga]Ga-DOTA-SSAs in routine practice.
MATERIALS AND METHODS: This is a secondary endpoint analysis from our multicenter trial (clin trial.gov identifier: NCT04552847) including 75 NEN patients who received both [68Ga]Ga-DOTATATE (n = 56) or [68Ga]Ga-DOTA-NOC (n = 19) and [18F]AlF-OC PET imaging. Five readers assessed lesion detection and characterization across multiple organs, scoring lesions by number and conspicuity using a 5-point Likert scale. Agreement was measured using Gwet's agreement coefficient.
RESULTS: Results demonstrated nearly perfect interobserver agreement for lesion characterization across all organs for both tracers (0.921 for [18F]AlF-OC; 0.934 for [68Ga]Ga-DOTA-SSA). Similar agreement was observed for the number of lesions across organs (0.736 for [18F]AlF-OC and 0.749 for [68Ga]Ga-DOTA-SSAs). Organ-specific analysis revealed strong agreement for bone and liver lesions, with slightly lower agreement for lymph nodes. Both tracers also showed excellent agreement in determining Krenning scores (0.925 for [18F]AlF-OC and 0.927 for [68Ga]Ga-DOTA-SSAs). While mean lesion conspicuity was similar between tracers, [18F]AlF-OC had a higher global image quality score (4.22 vs. 3.86, p < 0.0001). Intraobserver agreement was consistent between tracers for lesion characterization (> 0.95 for both readers) and lesion count (> 0.80 for both readers).
CONCLUSION: [18F]AlF-OC and [68Ga]Ga-DOTA-SSAs demonstrate comparable and excellent inter- and intraobserver agreement, reinforcing the clinical interchangeability of [18F]AlF-OC PET/CT with [68Ga]Ga-DOTA-SSAs in routine practice.