Evidence map›Paper›PMID 27705948›Full record

Trial reportOncotarget2017

Survival prediction in patients undergoing radionuclide therapy based on intratumoral somatostatin-receptor heterogeneity.

Rudolf A Werner, Constantin Lapa, Harun Ilhan, Takahiro Higuchi, Andreas K Buck, Sebastian Lehner, Peter Bartenstein, Frank Bengel, Imke Schatka, Dirk O Muegge and 5 more

Abstract readClinical TrialMulticenter Study
In one paragraph

Trial report in Oncotarget, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers.

0numbers the graph read from it
0cells of the map it votes in
51citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

51 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Applications of artificial intelligence in nuclear medicine.Zeitschrift fur medizinische Physik · 2026
    Review
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  5. Imaging-derived biomarkers fromCancer imaging : the official publication of the International Cancer Imaging Society · 2025
    Article
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  7. Article
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  9. Article
  10. Article
  11. Models using comprehensive, lesion-level, longitudinal [European journal of nuclear medicine and molecular imaging · 2024
    Article
  12. Article
  13. Review
  14. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Rudolf A WernerDepartment of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
Constantin LapaDepartment of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
Harun IlhanDepartment of Nuclear Medicine, Ludwig-Maximilians-University Munich, Munich, Germany.
Takahiro HiguchiDepartment of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
Andreas K BuckDepartment of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
Sebastian LehnerDepartment of Nuclear Medicine, Ludwig-Maximilians-University Munich, Munich, Germany.
Peter BartensteinDepartment of Nuclear Medicine, Ludwig-Maximilians-University Munich, Munich, Germany.
Frank BengelDepartment of Nuclear Medicine, Hannover Medical School, Hannover, Germany.
Imke SchatkaDepartment of Nuclear Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Dirk O MueggeUniversity of Applied Sciences, Hamburg, Germany.
László PappDepartment of Nuclear Medicine, Medical University of Vienna, Vienna, Austria.
Norbert ZsótérMediso Medical Imaging Systems Ltd., Budapest, Hungary.
Tobias Große-OphoffDepartment of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany.
Markus EsslerDepartment of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany.
Ralph A BundschuhDepartment of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The NETTER-1 trial demonstrated significantly improved progression-free survival (PFS) for peptide receptor radionuclide therapy (PRRT) in neuroendocrine tumors (NET) emphasizing the high demand for response prediction in appropriate candidates. In this multicenter study, we aimed to elucidate the prognostic value of tumor heterogeneity as assessed by somatostatin receptor (SSTR)-PET/CT. 141 patients with SSTR-expressing tumors were analyzed obtaining SSTR-PET/CT before PRRT (1-6 cycles, 177Lu somatostatin analog). Using the Interview Fusion Workstation (Mediso), a total of 872 metastases were manually segmented. Conventional PET parameters as well as textural features representing intratumoral heterogeneity were computed. The prognostic ability for PFS and overall survival (OS) were examined. After performing Cox regression, independent parameters were determined by ROC analysis to obtain cut-off values to be used for Kaplan-Meier analysis. Within follow-up (median, 43.1 months), 75 patients showed disease progression (median, 22.2 m) and 54 patients died (median, 27.6 m). Cox analysis identified 8 statistically independent heterogeneity parameters for time-to-progression and time-to-death. Among them, the textural feature Entropy predicted both PFS and OS. Conventional PET parameters failed in response prediction. Imaging-based heterogeneity assessment provides prognostic information in PRRT candidates and outperformed conventional PET parameters. Its implementation in clinical practice can pave the way for individualized patient management.

Indexed as

AdultAgedAged, 80 and overDisease-Free SurvivalFemaleHumansMaleMiddle AgedNeoplasm MetastasisNeuroendocrine TumorsOctreotideOrganometallic CompoundsPositron Emission Tomography Computed TomographyPrognosisReceptors, SomatostatinROC Curvelutetium Lu 177 dotatateOctreotideOrganometallic CompoundsReceptors, Somatostatinneuroendocrine tumorradiopeptide therapySSTR-PET/CTtextural parameterstumor heterogeneity

Identifiers

PMID27705948
PMCPMC5351689

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.