The value of ⁶⁸Ga-DOTA-TATE and ⁶⁴Cu-DOTA-TATE PET/CT in the diagnosis of neuroendocrine neoplasms

Neuroendocrine neoplasms (NEN) are a kind of heterogeneous tumors with great difference in invasion and prognosis. In recent years, its incidence and prevalence have increased year by year. The early diagnosis of NEN is difficult. Somatostatin receptor imaging has always been the main method for the diagnosis and staging of NEN patients. The ⁶⁴Cu and ⁶⁸Ga labeled somatostatin analogs such as ⁶⁴Cu-1, 4, 7, 10-tetraazacyclododecane -1, 4, 7, 10-tetraacetic acid-D-Phel-Tyr3-Thr8-octreotide (⁶⁴Cu-DOTA-TATE) and ⁶⁸Ga-DOTA-TATE have been approved by the US Food and Drug Administration to be used for imaging of NEN and other somatostatin receptor positive tumors. Although ⁶⁸Ga-DOTA-TATE has been widely used in clinical practice, but due to the high ⁶⁸Ga β energy limits spatial resolution of PET, and the short half-life also poses a challenge to its transport. In order to overcome the shortcomings of ⁶⁸Ga, the research of ⁶⁴Cu-labeled somatostatin analogues has developed rapidly. The longer half-life makes the accessibility of ⁶⁴Cu-DOTA-TATE higher than ⁶⁸Ga-DOTA-TATE. Because of its reduced dependence on the on-site cyclotron, ⁶⁴Cu and it labeled tracer can be transported to PET centers far away, which is very suitable for centralized production and distribution. The authors compared the properties and sources of the two radionuclides, as well as the advantages and disadvantages of ⁶⁸Ga-DOTA-TATE and ⁶⁴Cu-DOTA-TATE PET/CT in diagnosis of NEN. From the perspective of imaging performance and supply chain, ⁶⁴Cu-DOTA-TATE may have more clinical application value and wider development prospects than ⁶⁸Ga-DOTA-TATE.