Evaluation of 68Gallium-DOTATATE PET/CT for Detecting Neuroendocrine Tumors

• Sponsor: National Cancer Institute (NCI) (NIH)
• Overall Status: Completed
• CT.gov ID: NCT01967537
• Collaborator: (none)
• Enrollment: 341
• Location: 1
• Arm: 1
• Actual Duration (Months): 52.8
• Patients Per Site Per Month: 6.5

Study Details

Study Description

Brief Summary

Background:

• Neuroendocrine tumors (NETs) are rare but have been more common over the past decade. The only treatment for NETs is surgery, but most are found when they are too advanced for surgery. Researchers are looking for the best way to find NETs earlier, so that surgery can be successful. They want to test if the study drug can be used along with imaging devices to detect NETs.

Objectives:

• To see how well a new experimental imaging agent, 68Gallium-DOTATATE, detects unknown primary and metastatic NETs in the gastrointestinal system and pancreas.

Eligibility:

• Adults over 10 years old with a suspected NET or family history of NET.

Design:

• Participants will be screened with a medical history and physical exam, and have a blood test.

• Participants will undergo three scans. For all of these, a substance is injected into their body, they lie on a table, and a machine takes images.

• A standard computed tomography (CT) scan of the chest, abdomen, and pelvis.

• An octreotide scintigraphy Single photon emission computed tomography (SPECT)/CT.

• A 68Gallium-DOTATATE positron emission tomography (PET)/CT. The study drug is injected into a vein, usually in the arm. Low-dose X-rays go through the body. For about 40 minutes a large, donut-shaped device takes images of the body. The entire session takes 90 to 120 minutes.

• Researchers will compare images from the three scans.

• Participants will have 1 follow-up visit each year for 5 years. At this visit, they will have a medical exam, blood taken, and a CT scan.

Condition or Disease	Intervention/Treatment	Phase
Neuroendocrine Tumors; Von Hippel-Lindau Syndrome; Hippel-Lindau Disease	Drug: 68Gallium DOTATATE; Procedure: Radio-guided surgery	Phase 2

Detailed Description

Background:

• Neuroendocrine tumors (NETs) are rare malignancies occurring in the gastrointestinal tract, islets of the pancreas, lung, adrenal medulla and thyroid C-cells.

• Their incidence has increased over the last decade, with an incidence of 6 per 100,000 persons a year and they represent 0.46% of all malignancies.

• Most NETs are sporadic, but they can be part of familial cancer syndromes such as multiple endocrine neoplasia type 1 (MEN1), MEN2, and neurofibromatosis type 1 (NF1) or Von Hippel-Lindau (VHL) syndrome.

• Surgical resection remains the only curative treatment option for patients with NETs but 80% of patients are diagnosed with advanced (metastatic, locally inoperable, or recurrent) disease.

• The main prognostic factor in patients with NET is the extent of disease.

• The best imaging technique for detecting unknown primary and metastatic NETs has yet to be determined.

• NET cells express somatostatin receptors that can be targeted with radiolabeled 68Gallium-DOTATATE (Octreotate) for imaging purposes.

• The primary goal of this protocol is to determine the accuracy of a new somatostatin receptor targeted imaging technique, using 68Gallium-DOTATATE PET/CT to detect unknown primary and metastatic NETs.

Objectives:

-To determine the accuracy of 68Gallium-DOTATATE PET/CT scans in detecting unknown primary and metastatic gastrointestinal and pancreatic neuroendocrine tumors.

Eligibility:

• Patients with:

• suspicion of NET on axial imaging (CT/magnetic resonance imaging (MRI)/fluorodeoxyglucose-positron emission tomography (FDG PET) and/or

• biochemical evidence of NET (serum/urinary) based on elevated levels of chromogranin A, pancreatic polypeptide, neuron-specific enolase, vasoactive intestinal polypeptide, serotonin (urinary 5-HIAA), gastrin, somatostatin, catecholamines, metanephrines, calcitonin, fasting insulin, C-peptide (proinsulin), glucagon and/or

• familial predisposition to NET in patients with multiple endocrine neoplasia type 1 (MEN1) and VHL.

• Age greater than or equal to 18 years of age.

• Patients must be willing to return to National Institutes of Health (NIH) for follow-up.

Design:

• Prospective study.

• A 68Ga-DOTATATE PET/CT scan will be done in patients with suspicious lesions, unknown primary tumor or metastatic gastrointestinal or pancreatic neuroendocrine disease found on anatomic imaging (CT/MRI) or in patients having biochemically active disease.

• Both functional and non-functional solid tumors will be included in this study. Furthermore, asymptomatic and symptomatic, sporadic and familial cases of NETs (such as Von Hippel-Lindau (VHL), MEN1) will be included.

• Demographic, clinical and pathologic data will be collected from the medical record and patient interview for each patient. Data will be stored in a computerized database.

• After their initial on-study evaluation, patients will be staged according to findings on imaging studies with respect to primary tumor site, size and metastases. Surgical resection of NET and/or medical managements will be recommended based on standard practice guidelines. In patients who undergo surgical treatment, the samples will be immediately stored until molecular analysis.

• Follow up will be done yearly for a total duration of 5 years. This includes a yearly imaging study and a biochemical and clinical evaluation, to assess tumor growth and disease progression.

• We estimate that the accrual rate will be 3-10 patients per month; the total accrual period for this study will be 10 months to 3 years.

Study Design

• Study Type: Interventional
• Actual Enrollment: 341 participants
• Allocation: N/A
• Intervention Model: Single Group Assignment
• Masking: None (Open Label)
• Primary Purpose: Diagnostic
• Official Title: Evaluation of (68)Gallium- DOTATATE PET/CT for Detecting Primary and Metastatic Neuroendocrine Tumors
• Actual Study Start Date: Oct 18, 2013
• Actual Primary Completion Date: Dec 17, 2017
• Actual Study Completion Date: Mar 12, 2018

Arms and Interventions

Arm

Intervention/Treatment

Experimental: 68Gallium DOTATATE imaging 68Gallium DOTATATE imaging

Drug: 68Gallium DOTATATE; Fasting is not required prior to the imaging study. An IV line with a large bore (21 gauge or more) will be placed preferably in the antecubital vein, and, with the patient supine, around 5mCi of the 68Ga-DOTATATE will be administered intravenously, followed by incubation for approximately 60 minutes. Then the patient will be positioned in a PET/CT scanner and images from the upper thighs to the base of the skull will be obtained. In patients with tumor induced osteomalacia, images from the top of the head to the toes will be obtained.; Procedure: Radio-guided surgery; Using 68Gallium DOTATATE

Outcome Measures

Primary Outcome Measures

1. Number of Lesions Detected Using the 68Gallium-DOTATATE Positron Emission Tomography (PET/Computed Tomography (CT)) Scan [During PET Scan, up to 2 hours annually for up to 5 years]

   Patients with neuroendocrine tumors (NETs) were scanned with the 68Gallium-DOTATATE Positron Emission Tomography (PET/Computed Tomography (CT)) and the number of lesions detected are collected.

Secondary Outcome Measures

1. Mean Radiation Activity Between Low Grade and Intermediate Grade Neuroendocrine Tumor [During radioguided surgery, up to 2 hours]

   The radioactivity was assessed using intraoperative radiation detector following the 68Gallium-DOTATATE injection. Low grade neuroendocrine tumors is defined as tumors with slow cell division determined in histology. Low grade tumors is associated with the best outcome. Intermediate grade tumor is defined as the tumor with medium (3-20%) rate of actively dividing cells and is associated with less favorably outcome.

2. Tumor Volume of Neuroendocrine Tumors Assessed by the 68Gallium-DOTATATE Scan [During radioguided surgery, up to 2 hours]

   Participants were scanned using the 68Gallium-DOTATATE Scan. Tumor volume more than 7ml is associated with shorter time to disease progression. Tumor volume more than 36 ml is associated with shorter disease specific survival.

3. Median Radioactivity of Tumors With High Expression of Somatostatin Receptor 2 Compared to Tumors With Intermediate Expression of Somatostatin Receptor 2 [During PET Scan, up to 2 hours annually]

   High expression of somatostatin receptor 2 (SSTR2) is based on the intensity grading on immunohistochemistry. High SSTR2 expression may be associated with well-differentiated tumor and high avidity on DOTATATE scan, compared to intermediate or low expression of SSTR that can be seen in poorly differentiated and often aggressive neuroendocrine tumors. Because the correlation can only be from the comparison of preoperative DOTATATE and the tumors that were removed, it is a one time analysis. Subsequent DOTATATE studies are for surveillance and follow up for disease progression or recurrence.

4. The Number of Tumors Identified in Participants by the Radiation Detector During Radio-guided Surgery Using 68Gallium-DOTATATE [Radio-guided surgery, up to 2 hours]

   Radio-guided surgery in neuroendocrine tumors using 68Gallium-DOTATATE was performed to detect tumors in the stomach and small bowel neuroendocrine tumors, pancreas, metastatic sites to lymph nodes and liver, and pheochromocytoma or paraganglioma. The number of tumors identified by the radiation detector were assessed.

5. Count of Participants With Serious and Non-serious Adverse Events Assessed by the Common Terminology Criteria in Adverse Events (CTCAE v4.0) [Date treatment consent signed to date off study, approximately 50 months and 17 days.]

   Here is the count of participants with serious and non-serious adverse events assessed by the Common Terminology Criteria in Adverse Events (CTCAE v4.0). A non-serious adverse event is any untoward medical occurrence. A serious adverse event is an adverse event or suspected adverse reaction that results in death, a life threatening adverse drug experience, hospitalization, disruption of the ability to conduct normal life functions, congenital anomaly/birth defect or important medical events that jeopardize the patient or subject and may require medical or surgical intervention to prevent one of the previous outcomes mentioned.

Eligibility Criteria

Criteria

• Ages Eligible for Study: 10 Years to 99 Years
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

• INCLUSION CRITERIA:

• Patients with (any one of #1, #2, and/or #3):

1. Suspicion of neuroendocrine tumors (NET) on axial imaging (computed tomography (CT)/magnetic resonance imaging (MRI)/fluorodeoxyglucose (FDG) positron emission tomography (PET) and/or

2. biochemical evidence of neuroendocrine tumor (serum/urinary) based on elevated levels of chromogranin A, pancreatic polypeptide, neuron-specific enolase, vasoactive intestinal polypeptide, serotonin (urinary 5-HIAA), gastrin, somatostatin, catecholamines, metanephrines, calcitonin, fasting insulin, C-peptide (proinsulin), glucagon and/or

3. familial predisposition to NET in patients with multiple endocrine neoplasia type 1 (MEN1) and Von Hippel-Lindau (VHL) (symptomatic and/or asymptomatic cases; with biochemical or anatomic imaging evidence of disease).

• Age greater than or equal to 10 years of age.

• For females: Negative urine pregnancy test OR post-menopausal for at least 2 years OR patient has had a hysterectomy.

• Patients must be willing to return to National Institutes of Health (NIH) for follow-up.

• Ability of subject or Legally Authorized Representative (LAR) (if the patient is deemed by the treating physician to be cognitively impaired or questionably impaired in such a way that the ability of the patient to give informed consent is questionable) to understand and the willingness to sign a written informed consent document indicating that they are aware of the investigational nature of this study.

EXCLUSION CRITERIA:

• Patients unwilling to undergo serial non-invasive imaging.

• Pregnant or lactating women: Pregnant women are excluded from this study because the effects of (68)Ga-DOTATATE in pregnancy are not known. Because there is an unknown but potential risk for adverse events in nursing infants secondary to administration of

(68)Ga-DOTATATE in the mother, breastfeeding should be discontinued for at least one day if the mother receives (68)Ga-DOTATATE.

• Patients that have recognized concurrent active infection,

• Patients with the use of any investigational product or device, excluding 18F-dihydroxyphenylalanine (F-DOPA) scans, within 30 days prior to dosing.

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	National Institutes of Health Clinical Center	Bethesda	Maryland	United States	20892

Sponsors and Collaborators

• National Cancer Institute (NCI)

Investigators

• Principal Investigator: Naris Nilubol, M.D., National Cancer Institute (NCI)

Study Documents (Full-Text)

• Study Protocol, Statistical Analysis Plan, and Informed Consent Form - Oct 31, 2017

More Information

Additional Information:

• NIH Clinical Center Detailed Web Page

Publications

• Lawrence B, Gustafsson BI, Chan A, Svejda B, Kidd M, Modlin IM. The epidemiology of gastroenteropancreatic neuroendocrine tumors. Endocrinol Metab Clin North Am. 2011 Mar;40(1):1-18, vii. doi: 10.1016/j.ecl.2010.12.005. Review.
• Modlin IM, Lye KD, Kidd M. A 5-decade analysis of 13,715 carcinoid tumors. Cancer. 2003 Feb 15;97(4):934-59.
• Tsikitis VL, Wertheim BC, Guerrero MA. Trends of incidence and survival of gastrointestinal neuroendocrine tumors in the United States: a seer analysis. J Cancer. 2012;3:292-302. doi: 10.7150/jca.4502. Epub 2012 Jul 1.

• Responsible Party: Naris Nilubol, M.D., Principal Investigator, National Cancer Institute (NCI)
• ClinicalTrials.gov Identifier: NCT01967537
• Other Study ID Numbers: 130193; 13-C-0193
• First Posted: Oct 23, 2013
• Last Update Posted: Nov 19, 2019
• Last Verified: Nov 1, 2019

• Individual Participant Data (IPD) Sharing Statement: No
• Plan to Share IPD: No
• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: No
• Keywords provided by Naris Nilubol, M.D., Principal Investigator, National Cancer Institute (NCI): NET; MEN1; Von Hippel Lindau (VHL); Surgical Resection; Somatostatin Receptor Status
• Additional relevant MeSH terms: Neuroendocrine Tumors; Von Hippel-Lindau Disease

Study Results

Participant Flow

Arm/Group Title	68Gallium DOTATATE Imaging
Arm/Group Description	68Gallium DOTATATE imaging 68Gallium DOTATATE: Fasting is not required prior to the imaging study. An IV line with a large bore (21 gauge or more) will be placed preferably in the antecubital vein, and, with the patient supine, around 5mCi of the 68Ga-DOTATATE will be administered intravenously, followed by incubation for approximately 60 minutes. Then the patient will be positioned in a PET/CT scanner and images from the upper thighs to the base of the skull will be obtained. In patients with tumor induced osteomalacia, images from the top of the head to the toes will be obtained. Radio-guided surgery: Using 68Gallium DOTATATE
Period Title: Overall Study
STARTED	341
COMPLETED	281
NOT COMPLETED	60

Baseline Characteristics

Arm/Group Title	68Gallium DOTATATE Imaging
Arm/Group Description	68Gallium DOTATATE imaging 68Gallium DOTATATE: Fasting is not required prior to the imaging study. An IV line with a large bore (21 gauge or more) will be placed preferably in the antecubital vein, and, with the patient supine, around 5mCi of the 68Ga-DOTATATE will be administered intravenously, followed by incubation for approximately 60 minutes. Then the patient will be positioned in a PET/CT scanner and images from the upper thighs to the base of the skull will be obtained. In patients with tumor induced osteomalacia, images from the top of the head to the toes will be obtained. Radio-guided surgery: Using 68Gallium DOTATATE
Overall Participants	341
Age (Count of Participants)
<=18 years	1 0.3%
Between 18 and 65 years	238 69.8%
>=65 years	102 29.9%
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]	55.89 (14.43)
Sex: Female, Male (Count of Participants)
Female	194 56.9%
Male	147 43.1%
Race/Ethnicity, Customized (Count of Participants)
American Indian or Alaska Native	1 0.3%
Asian	9 2.6%
Black or African American	24 7%
Native Hawaiian or Other Pacific Islander	1 0.3%
Other	7 2.1%
Race Unknown	9 2.6%
White	290 85%
Hispanic or Latino	17 5%
Not Hispanic or Latino	323 94.7%
Ethnicity Unknown	1 0.3%
Region of Enrollment (Count of Participants)
United States	341 100%

Outcome Measures

1. Primary Outcome

Title	Number of Lesions Detected Using the 68Gallium-DOTATATE Positron Emission Tomography (PET/Computed Tomography (CT)) Scan
Description	Patients with neuroendocrine tumors (NETs) were scanned with the 68Gallium-DOTATATE Positron Emission Tomography (PET/Computed Tomography (CT)) and the number of lesions detected are collected.
Time Frame	During PET Scan, up to 2 hours annually for up to 5 years

Outcome Measure Data

Analysis Population Description

Analysis was performed in the initial 131/341 participants scanned because 52 withdrew consent and 2 refused treatment. Subsequent scans in the remaining 156 participants were used to assess secondary objectives.

Arm/Group Title	68Gallium DOTATATE Imaging
Arm/Group Description	68Gallium DOTATATE imaging 68Gallium DOTATATE: Fasting is not required prior to the imaging study. An IV line with a large bore (21 gauge or more) will be placed preferably in the antecubital vein, and, with the patient supine, around 5mCi of the 68Ga-DOTATATE will be administered intravenously, followed by incubation for approximately 60 minutes. Then the patient will be positioned in a PET/CT scanner and images from the upper thighs to the base of the skull will be obtained. In patients with tumor induced osteomalacia, images from the top of the head to the toes will be obtained. Radio-guided surgery: Using 68Gallium DOTATATE
Measure Participants	131
Number [Number of lesions]	847

2. Secondary Outcome

Title	Mean Radiation Activity Between Low Grade and Intermediate Grade Neuroendocrine Tumor
Description	The radioactivity was assessed using intraoperative radiation detector following the 68Gallium-DOTATATE injection. Low grade neuroendocrine tumors is defined as tumors with slow cell division determined in histology. Low grade tumors is associated with the best outcome. Intermediate grade tumor is defined as the tumor with medium (3-20%) rate of actively dividing cells and is associated with less favorably outcome.
Time Frame	During radioguided surgery, up to 2 hours

Outcome Measure Data

Analysis Population Description

As of 12/22/14 when the analysis was performed, 14/140 subjects required surgical intervention with intraoperative radiation detector and thus were analyzed. 126 participants were not surgical candidates or did not receive intraoperative dose of 68Gallium-DOTATATE and did not have radiation detector.

Arm/Group Title	68Gallium DOTATATE Imaging
Arm/Group Description	68Gallium DOTATATE imaging 68Gallium DOTATATE: Fasting is not required prior to the imaging study. An IV line with a large bore (21 gauge or more) will be placed preferably in the antecubital vein, and, with the patient supine, around 5mCi of the 68Ga-DOTATATE will be administered intravenously, followed by incubation for approximately 60 minutes. Then the patient will be positioned in a PET/CT scanner and images from the upper thighs to the base of the skull will be obtained. In patients with tumor induced osteomalacia, images from the top of the head to the toes will be obtained. Radio-guided surgery: Using 68Gallium DOTATATE
Measure Participants	14
Low grade	504.9 (534)
Intermediate grade	205 (147)

3. Secondary Outcome

Title	Tumor Volume of Neuroendocrine Tumors Assessed by the 68Gallium-DOTATATE Scan
Description	Participants were scanned using the 68Gallium-DOTATATE Scan. Tumor volume more than 7ml is associated with shorter time to disease progression. Tumor volume more than 36 ml is associated with shorter disease specific survival.
Time Frame	During radioguided surgery, up to 2 hours

Outcome Measure Data

Analysis Population Description

184/341 participants were analyzed because 52 withdrew consent and 2 refused treatment, 22 did not have a diagnosis of neuroendocrine tumor, and 81 had no 68Ga-DOTATATE uptake and were excluded.

Arm/Group Title	68Gallium DOTATATE Imaging
Arm/Group Description	68Gallium DOTATATE imaging 68Gallium DOTATATE: Fasting is not required prior to the imaging study. An IV line with a large bore (21 gauge or more) will be placed preferably in the antecubital vein, and, with the patient supine, around 5mCi of the 68Ga-DOTATATE will be administered intravenously, followed by incubation for approximately 60 minutes. Then the patient will be positioned in a PET/CT scanner and images from the upper thighs to the base of the skull will be obtained. In patients with tumor induced osteomalacia, images from the top of the head to the toes will be obtained. Radio-guided surgery: Using 68Gallium DOTATATE
Measure Participants	184
Median (Full Range) [ml]	9.24

4. Secondary Outcome

Title	Median Radioactivity of Tumors With High Expression of Somatostatin Receptor 2 Compared to Tumors With Intermediate Expression of Somatostatin Receptor 2
Description	High expression of somatostatin receptor 2 (SSTR2) is based on the intensity grading on immunohistochemistry. High SSTR2 expression may be associated with well-differentiated tumor and high avidity on DOTATATE scan, compared to intermediate or low expression of SSTR that can be seen in poorly differentiated and often aggressive neuroendocrine tumors. Because the correlation can only be from the comparison of preoperative DOTATATE and the tumors that were removed, it is a one time analysis. Subsequent DOTATATE studies are for surveillance and follow up for disease progression or recurrence.
Time Frame	During PET Scan, up to 2 hours annually

Outcome Measure Data

Analysis Population Description

As of 12/22/14 when the analysis was performed, 12/140 subj. required surgical intervention with intraoperative radiation detector & thus were analyzed. 12 subj. had their tumors analyzed for the expression of SSTR, 126 subj. were not surgical candidates or did not receive intraoperative dose of 68Gallium-DOTATATE & did not have radiation detector.

Arm/Group Title	68Gallium DOTATATE Imaging
Arm/Group Description	68Gallium DOTATATE imaging 68Gallium DOTATATE: Fasting is not required prior to the imaging study. An IV line with a large bore (21 gauge or more) will be placed preferably in the antecubital vein, and, with the patient supine, around 5mCi of the 68Ga-DOTATATE will be administered intravenously, followed by incubation for approximately 60 minutes. Then the patient will be positioned in a PET/CT scanner and images from the upper thighs to the base of the skull will be obtained. In patients with tumor induced osteomalacia, images from the top of the head to the toes will be obtained. Radio-guided surgery: Using 68Gallium DOTATATE
Measure Participants	12
High expression	6.5
Low expression	3.7

Statistical Analysis 1

Statistical Analysis Overview	Comparison Group Selection	68Gallium DOTATATE Imaging
	Comments
	Type of Statistical Test	Superiority
	Comments
Statistical Test of Hypothesis	p-Value	0.23
	Comments
	Method	Mann-Whitney
	Comments

5. Secondary Outcome

Title	The Number of Tumors Identified in Participants by the Radiation Detector During Radio-guided Surgery Using 68Gallium-DOTATATE
Description	Radio-guided surgery in neuroendocrine tumors using 68Gallium-DOTATATE was performed to detect tumors in the stomach and small bowel neuroendocrine tumors, pancreas, metastatic sites to lymph nodes and liver, and pheochromocytoma or paraganglioma. The number of tumors identified by the radiation detector were assessed.
Time Frame	Radio-guided surgery, up to 2 hours

Outcome Measure Data

Analysis Population Description

As of 02.14.2018 when the analysis was performed, 44/326 subjects required surgical intervention with intraoperative radiation detector and thus were analyzed for the number of tumors identified. 282 participants were not surgical candidates and did not receive intraoperative dose of 68 Gallium-DOTATATE and did not have radiation detector used.

Arm/Group Title	68Gallium DOTATATE Imaging
Arm/Group Description	68Gallium DOTATATE imaging 68Gallium DOTATATE: Fasting is not required prior to the imaging study. An IV line with a large bore (21 gauge or more) will be placed preferably in the antecubital vein, and, with the patient supine, around 5mCi of the 68Ga-DOTATATE will be administered intravenously, followed by incubation for approximately 60 minutes. Then the patient will be positioned in a PET/CT scanner and images from the upper thighs to the base of the skull will be obtained. In patients with tumor induced osteomalacia, images from the top of the head to the toes will be obtained. Radio-guided surgery: Using 68Gallium DOTATATE
Measure Participants	44
Stomach and small bowel	23
Pancreas tumors	24
Pheochromocytoma and paraganglioma	6
Liver metastasis	9
Metastatic lymph nodes	71

6. Secondary Outcome

Title	Count of Participants With Serious and Non-serious Adverse Events Assessed by the Common Terminology Criteria in Adverse Events (CTCAE v4.0)
Description	Here is the count of participants with serious and non-serious adverse events assessed by the Common Terminology Criteria in Adverse Events (CTCAE v4.0). A non-serious adverse event is any untoward medical occurrence. A serious adverse event is an adverse event or suspected adverse reaction that results in death, a life threatening adverse drug experience, hospitalization, disruption of the ability to conduct normal life functions, congenital anomaly/birth defect or important medical events that jeopardize the patient or subject and may require medical or surgical intervention to prevent one of the previous outcomes mentioned.
Time Frame	Date treatment consent signed to date off study, approximately 50 months and 17 days.

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	68Gallium DOTATATE Imaging
Arm/Group Description	68Gallium DOTATATE imaging 68Gallium DOTATATE: Fasting is not required prior to the imaging study. An IV line with a large bore (21 gauge or more) will be placed preferably in the antecubital vein, and, with the patient supine, around 5mCi of the 68Ga-DOTATATE will be administered intravenously, followed by incubation for approximately 60 minutes. Then the patient will be positioned in a PET/CT scanner and images from the upper thighs to the base of the skull will be obtained. In patients with tumor induced osteomalacia, images from the top of the head to the toes will be obtained. Radio-guided surgery: Using 68Gallium DOTATATE
Measure Participants	341
Count of Participants [Participants]	21 6.2%

Adverse Events

Time Frame	Date treatment consent signed to date off study, approximately 50 months and 17 days.
Arm/Group Title	68Gallium DOTATATE Imaging
Arm/Group Description	68Gallium DOTATATE imaging 68Gallium DOTATATE: Fasting is not required prior to the imaging study. An IV line with a large bore (21 gauge or more) will be placed preferably in the antecubital vein, and, with the patient supine, around 5mCi of the 68Ga-DOTATATE will be administered intravenously, followed by incubation for approximately 60 minutes. Then the patient will be positioned in a PET/CT scanner and images from the upper thighs to the base of the skull will be obtained. In patients with tumor induced osteomalacia, images from the top of the head to the toes will be obtained. Radio-guided surgery: Using 68Gallium DOTATATE
All Cause Mortality
	68Gallium DOTATATE Imaging
	Affected / at Risk (%)	# Events
Total	16/341 (4.7%)
Serious Adverse Events
	68Gallium DOTATATE Imaging
	Affected / at Risk (%)	# Events
Total	20/341 (5.9%)
General disorders
Death (unrelated to 68 Gallium DOTATATE)	16/341 (4.7%)	16
Metabolism and nutrition disorders
Hyperglycemia	1/341 (0.3%)	1
Vascular disorders
Thromboembolic event	3/341 (0.9%)	3
Other (Not Including Serious) Adverse Events
	68Gallium DOTATATE Imaging
	Affected / at Risk (%)	# Events
Total	1/341 (0.3%)
Nervous system disorders
Alteration of consciousness	1/341 (0.3%)	1

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

Principal Investigators are NOT employed by the organization sponsoring the study.

There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.