Journal Article

Validation of the SSTR-RADS 1.0 for the structured interpretation of SSTR-PET/CT and treatment planning in neuroendocrine tumor (NET) patients

Ebner, Ricarda, Cyran, Clemens C, Fabritius, Matthias P, Ruebenthaler, Johannes, Auernhammer, Christoph J, Sheikh, Gabriel T, Heimer, Maurice M, Spitzweg, Christine, Eschbach, Ralf, Grawe, Freba, Beyer, Leonie, Winkelmann, Michael, Geyer, Thomas, Schmid-Tannwald, Christine, Faggioni, Lorenzo, Ricke, Jens, Bartenstein, Peter

2023

Overview

Objectives The recently proposed standardized reporting and data system for somatostatin receptor (SSTR)–targeted PET/CT SSTR-RADS 1.0 showed promising first results in the assessment of diagnosis and treatment planning with peptide receptor radionuclide therapy (PRRT) in neuroendocrine tumors (NET). This study aimed to determine the intra- and interreader agreement of SSTR-RADS 1.0. Methods SSTR-PET/CT scans of 100 patients were independently evaluated by 4 readers with different levels of expertise according to the SSTR-RADS 1.0 criteria at 2 time points within 6 weeks. For each scan, a maximum of five target lesions were freely chosen by each reader (not more than three lesions per organ) and stratified according to the SSTR-RADS 1.0 criteria. Overall scan score and binary decision on PRRT were assessed. Intra- and interreader agreement was determined using the intraclass correlation coefficient (ICC). Results Interreader agreement using SSTR-RADS 1.0 for identical target lesions (ICC ≥ 0.91) and overall scan score (ICC ≥ 0.93) was excellent. The decision to state “functional imaging fulfills requirements for PRRT and qualifies patient as potential candidate for PRRT” also demonstrated excellent agreement among all readers (ICC ≥ 0.86). Intrareader agreement was excellent even among different experience levels when comparing target lesion–based scores (ICC ≥ 0.98), overall scan score (ICC ≥ 0.93), and decision for PRRT (ICC ≥ 0.88). Conclusion SSTR-RADS 1.0 represents a highly reproducible and accurate system for stratifying SSTR-targeted PET/CT scans with high intra- and interreader agreement. The system is a promising approach to standardize the diagnosis and treatment planning in NET patients. Key Points • SSTR-RADS 1.0 offers high reproducibility and accuracy. • SSTR-RADS 1.0 is a promising method to standardize diagnosis and treatment planning for patients with NET.

• Publisher: Springer Science and Business Media LLC,Springer Berlin Heidelberg,Springer Nature B.V
• Subject: Agreements / Computed tomography / Correlation coefficient / Correlation coefficients / Criteria / Data systems / Diagnosis / Diagnostic Radiology / Humans / Imaging / Internal Medicine / Interventional Radiology / Lesions / Medical diagnosis / Medical imaging / Medicine / Medicine & Public Health / Molecular Imaging / Neuroendocrine Tumors / Neuroendocrine Tumors - diagnostic imaging / Neuroendocrine Tumors - pathology / Neuroendocrine Tumors - therapy / Neuroendocrine tumors; Positron emission tomography computed tomography; Somatostatin / Neuroradiology / Positron emission / Positron emission tomography / Positron Emission Tomography Computed Tomography / Radiation therapy / Radioisotopes / Radiology / Radionuclide Imaging / Receptors / Receptors, Somatostatin / Reproducibility / Reproducibility of Results / Somatostatin / Somatostatin receptors / Tumors / Ultrasound