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Open Access Research article

Somatostatin receptor expression in Merkel cell carcinoma as target for molecular imaging

Kristina Buder12*, Constantin Lapa3, Michael C Kreissl34, Andreas Schirbel3, Ken Herrmann3, Alexander Schnack5, Eva-Bettina Bröcker1, Matthias Goebeler1, Andreas K Buck3 and Jürgen C Becker16

  • * Corresponding author: Kristina Buder Buder_K@ukw.de

  • † Equal contributors

Author Affiliations

1 Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Josef-Schneider-Strasse 2, 97080 Würzburg, Germany

2 Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, Josef-Schneider-Strasse 6, 97080 Würzburg, Germany

3 Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacher Strasse 6, 97080 Würzburg, Germany

4 Department of Nuclear Medicine, Central Hospital of Augsburg, Stenglinstr.2, 86156 Augsburg, Germany

5 Department of Radiology, University Hospital Würzburg, Oberdürrbacher Strasse 6, 97080 Würzburg, Germany

6 Department of General Dermatology, Medical University Graz, Auenbrugger Platz 1, 8036 Graz, Austria

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BMC Cancer 2014, 14:268  doi:10.1186/1471-2407-14-268

Published: 17 April 2014

Abstract

Background

Merkel cell carcinoma (MCC) is a rare cutaneous neoplasm with increasing incidence, aggressive behavior and poor prognosis. Somatostatin receptors (SSTR) are expressed in MCC and represent a potential target for both imaging and treatment.

Methods

To non-invasively assess SSTR expression in MCC using PET and the radiotracers [68Ga]DOTA-D-Phe1-Tyr3-octreotide (DOTATOC) or -octreotate (DOTATATE) as surrogate for tumor burden. In 24 patients with histologically proven MCC SSTR-PET was performed and compared to results of computed tomography (CT).

Results

SSTR-PET detected primary and metastatic MCC lesions. On a patient-based analysis, sensitivity of SSTR-PET was 73% for nodal metastases, 100% for bone, and 67% for soft-tissue metastases, respectively. Notably, brain metastases were initially detected by SSTR-PET in 2 patients, whereas liver and lung metastases were diagnosed exclusively by CT. SSTR-PET showed concordance to CT results in 20 out of 24 patients. Four patients (17%) were up-staged due to SSTR-PET and patient management was changed in 3 patients (13%).

Conclusion

SSTR-PET showed high sensitivity for imaging bone, soft tissue and brain metastases, and particularly in combination with CT had a significant impact on clinical stage and patient management.

Keywords:
Merkel cell carcinoma; Molecular imaging; Somatostatin receptor expression; Positron emission tomography