68Ga-DOTATATE PET/CT在鉴别胰腺神经内分泌肿瘤与钩突中的价值

doi:10.16150/j.1671-2870.2026.02.010

摘要/Abstract

摘要：

目的：在⁶⁸Ga-DOTATATE PET/CT图像中，观察胰腺神经内分泌肿瘤（neuroendocrine tumor， NET）、胰腺钩突组织及其他胰腺肿瘤对⁶⁸Ga-DOTATATE摄取的差异，分析其鉴别效能。方法：2020年1月至2022年6月，连续入组因怀疑NET而进行⁶⁸Ga-DOTATATE PET/CT检查的患者133例（58例经病理确诊为胰腺NET，12例经病理确诊为胰腺其他肿瘤，63例经随访确认为非胰腺肿瘤）。回顾性分析病例资料，共获取158个⁶⁸Ga-DOTATATE高摄取的目标区域，将目标区域分为胰腺钩突生理摄取、胰腺NET和其他胰腺肿瘤3组。比较3组间目标区域在⁶⁸Ga-DOTATATE PET/CT图像上最大标准摄取值（maximum standard uptake value， SUVmax）和平均标准摄取值（mean standard uptake value， SUVmean）的差异，计算目标区域与脾脏（SUVmax-T/SUVmax-S、SUVmean-T/SUVmean-S）或者肝脏（SUVmax-T/SUVmax-L、SUVmean-T/SUVmean-L）摄取值的比值。采用受试者操作特征（receiver operating characteristic，ROC）曲线分析评估不同参数对胰腺不同病灶的鉴别能力。结果：胰腺NET对⁶⁸Ga-DOTATATE的摄取显著高于其他胰腺肿瘤及钩突生理摄取[SUVmax依次为（54.87±35.77）、（27.70±51.55）、（8.94±3.04），P均<0.05；SUVmean依次为（32.76±23.04）、（14.79±28.15）、（6.28±2.11），P均<0.05]。其他胰腺肿瘤对⁶⁸Ga-DOTATATE的摄取高于钩突，但除SUVmax以外，其他参数在两者间的差异无统计学意义（P>0.05）。SUVmax-T/SUVmax-S比值能准确地鉴别胰腺NET与非胰腺NET（胰腺其他肿瘤或胰腺钩突生理性摄取），当最佳临界值为大于0.802时，AUC为0.929，灵敏度为0.855，特异度为0.948。结论：在⁶⁸Ga-DOTATATE PET/CT检查中，胰腺钩突存在生理摄取的现象，SUVmax-T/SUVmax-S比值和SUVmean-T/SUVmean-S比值相关参数能准确鉴别胰腺NET与钩突生理摄取及胰腺其他肿瘤。

关键词: 神经内分泌肿瘤, 胰腺钩突, ⁶⁸Ga-DOTATATE, PET/CT, 受试者操作特征

Abstract:

Objective To observe the differences in ⁶⁸Ga-DOTATATE uptake among pancreatic neuroendocrine tumor (NET), the tissues of the pancreatic uncinate process, and other pancreatic tumors in ⁶⁸Ga-DOTATATE PET/CT images, and to analyze their diagnostic performance. Methods A retrospective study was conducted on 133 consecutively enrolled patients who underwent ⁶⁸Ga-DOTATATE PET/CT between January 2020 and June 2022 for suspected NET (58 cases were pathologically diagnosed with pancreatic NET, 12 cases with other pancreatic tumors, and 63 cases were confirmed as having non-pancreatic tumors during follow-up). Clinical data were retrospectively analyzed, and a total of 158 target regions with high ⁶⁸Ga-DOTATATE uptake were obtained and divided into three groups: physiological uptake in the pancreatic uncinate process, pancreatic NET, and other pancreatic tumors. Differences in maximum and mean standardized uptake values (SUVmax and SUVmean) among these groups were compared. The ratios of uptake in the target region to the spleen (SUVmax-T/SUVmax-S, SUVmean-T/SUVmean-S) or the liver (SUVmax-T/SUVmax-L, SUVmean-T/SUVmean-L) were calculated. The receiver opera-ting characteristic (ROC) curve analysis was used to assess the diagnostic ability of different parameters for various pancreatic lesions. Results ⁶⁸Ga-DOTATATE uptake in pancreatic NET was significantly higher than those in the physiological uptake in the uncinate process and other pancreatic tumors (SUVmax values were 54.87±35.77, 27.70±51.55, and 8.94±3.04, respectively, all P<0.05; SUVmean values were 32.76±23.04, 14.79±28.15, and 6.28±2.11, respectively, all P<0.05). The uptake of ⁶⁸Ga-DOTATATE in other pancreatic tumors was higher than that in the uncinate process, and except for SUVmax, there were no statistically significant differences in other parameters between the two groups (P>0.05). The SUVmax-T/SUVmax-S ratio accurately differentiated pancreatic NET from non-pancreatic NET (other pancreatic tumors or physiological uptake in the pancreatic uncinate process), with an AUC of 0.929, a sensitivity of 0.855, a specificity of 0.948, and an optimal cutoff value greater than 0.802. Conclusions Physiological uptake can be observed in the pancreatic uncinate process on ⁶⁸Ga-DOTATATE PET/CT. Parameters related to the SUVmax-T/SUVmax-S and SUVmean-T/SUVmean-S ratios can accurately distinguish pancreatic NET from the physiological uptake in the pancreatic uncinate process and other pancreatic tumors.

Key words: Neuroendocrine tumors, Pancreatic uncinate process, ⁶⁸Ga-DOTATATE, PET/CT, Receiver operating characteristic

中图分类号:

R445
R735.9

李翔, 黄新韵, 郭睿, 李彪, 周熠磊. ⁶⁸Ga-DOTATATE PET/CT在鉴别胰腺神经内分泌肿瘤与钩突中的价值[J]. 诊断学理论与实践, 2026, 25(02): 193-199.

LI Xiang, HUANG Xinyun, GUO Rui, LI Biao, ZHOU Yilei. Value of ⁶⁸Ga-DOTATATE PET/CT in differentiating pancreatic neuroendocrine tumors from uncinate process of pancreas[J]. Journal of Diagnostics Concepts & Practice, 2026, 25(02): 193-199.

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参考文献 19

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Characteristics	Total（n=133）
Gender
Male	61 (45.87%)
Female	72 (54.14%)
Age (years)	48.86 ± 12.72
Diameter of pancreatic NET (cm)	3.51± 2.31
Location of pancreatic NET
Head and neck	24 (41.86%)
Body and tail	44(58.14%)
Pancreatic PET/CT target region(n =158)
Pancreatic NET	58(36.71%)
Non‑NET pancreatic tumor	12(7.6%)
Physiological uptake in uncinate process	88(55.69%)

Item	Pancreatic NET(n=58)	non‑NET pancreatic tumor(n=12)	Physiological uptake in uncinate process (n=88)	P value ^a)	P value ^b)	P value ^c)
SUVmax	54.87±35.77	27.70±51.55	8.94±3.04	0.001	0.019	<0.001
SUVmean	32.76±23.04	14.79±28.15	6.28±2.11	<0.001	0.084	<0.001
SUVmax-T/SUVmax-L	4.82±3.47	2.35±4.79	0.81±0.3	0.002	0.054	<0.001
SUVmean-T/SUVmean-L	6.46±11.91	1.95±4.1	0.9±0.34	0.054	0.643	<0.001
SUVmax-T/SUVmax-S	2.15±1.91	0.89±1.75	0.28±0.11	0.002	0.125	<0.001
SUVmean-T/SUVmean-S	1.77±1.64	0.64±1.35	0.27±0.11	0.001	0.26	<0.001

Item	AUC (95%CI)	P value	Sensitivity	Specificity	Cut-off value
SUVmax	0.949 (0.903-0.995)	<0.001	0.891	0.976	16
SUVmean	0.907 (0.840-0.975)	<0.001	0.836	0.988	10.81
SUVmax-T/SUVmax-L	0.924 (0.866-0.982)	<0.001	0.891	0.952	1.259
SUVmean-T/SUVmean-L	0.887 (0.813-0.960)	<0.001	0.818	0.952	1.416
SUVmax-T/SUVmax-S	0.964 (0.932-0.996)	<0.001	0.855	0.999	0.648
SUVmean-T/SUVmean-S	0.916 (0.855-0.976)	<0.001	0.818	0.976	0.531

Item	AUC (95%CI)	P value	Sensitivity	Specificity	Cut-off value
SUVmax	0.833(0.677-0.989)	<0.001	0.891	0.75	14.725
SUVmean	0.821(0.665-0.978)	0.001	0.891	0.75	7.550
SUVmax-T/SUVmax-L	0.829(0.670-0.987)	<0.001	0.891	0.75	1.259
SUVmean-T/SUVmean-L	0.838(0.690-0.986)	<0.001	0.855	0.833	1.193
SUVmax-T/SUVmax-S	0.853(0.699-1)	<0.001	0.764	0.917	0.861
SUVmean-T/SUVmean-S	0.855(0.703-1)	<0.001	0.836	0.833	0.494

⁶⁸Ga-DOTATATE PET/CT在鉴别胰腺神经内分泌肿瘤与钩突中的价值

Value of ⁶⁸Ga-DOTATATE PET/CT in differentiating pancreatic neuroendocrine tumors from uncinate process of pancreas

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