68Ga-DOTATOC PET/CT in the localization of head and neck paraganglioma compared with 18F-DOPA PET/CT and 123I-MIBG SPECT/CT

Alexander Stephan Kroiss; Christian Uprimny; Barry Lynn Shulkin; Leonhard Gruber; Andreas Frech; Christoph Url; Herbert Riechelmann; Georg Mathias Sprinzl; Claudius Thomé; Giorgio Treglia; Andreas Kjaer; Gustav Fraedrich; Irene Johanna Virgolini

doi:10.1016/j.nucmedbio.2019.04.003

68Ga-DOTATOC PET/CT in the localization of head and neck paraganglioma compared with 18F-DOPA PET/CT and 123I-MIBG SPECT/CT

Alexander Stephan Kroiss, Christian Uprimny, Barry Lynn Shulkin, Leonhard Gruber, Andreas Frech, Christoph Url, Herbert Riechelmann, Georg Mathias Sprinzl, Claudius Thomé, Giorgio Treglia, Andreas Kjaer, Gustav Fraedrich, Irene Johanna Virgolini

Division of Otorhinolaryngology (University Hospital St. Pölten)

Research output: Journal article (peer-reviewed) › Journal article

14 Citations (Scopus)

Abstract

PURPOSE: 18F-Fluoro-L-dihydroxyphenylalanine (18F-DOPA) PET offers high sensitivity and specificity in the imaging of non-malignant head and neck paraganglioma (HNPGL) but lower sensitivity in metastatic disease of these neuroendocrine tumours (NET). In contrast to the radiotracer 18F-DOPA, both 123I-meta-iodo-benzylguanidine (123I-MIBG) and 68Ga-DOTA-Tyr3-octreotide (68Ga-DOTA-TOC) offer valuable clinical information on norepinephrine and somatostatin (SST) receptor status for planning 131I-MIBG and radionuclide peptide therapy (PRRT), respectively. Therefore, we compared 68Ga-DOTA-TOC and 18F-DOPA PET/CT with 123I-MIBG planar and SPECT/CT imaging, for the detection of HNPGL. Combined cross-sectional imaging was the reference standard.

METHODS: A total of 3 men and 7 women (age range 22 to 73 years) with anatomical and/or histologically proven HNPGL were included in this study. Of these patients, 3 patients had metastatic HNPGL. Comparative evaluation included morphological imaging with CT and functional imaging with 68Ga-DOTA-TOC and 18F-DOPA PET, including 123I-MIBG imaging. The imaging results were analysed on a per-patient and per-lesion basis.

RESULTS: On a per-patient analysis, the detection rate of both 68Ga-DOTA-TOC PET/CT and 18F-DOPA PET/CT was 100%, that of planar 123I-MIBG imaging 10.0% and that of SPECT/CT 20.0%. On a per-lesion basis and in reference to diagnostic CT, the sensitivity of 68Ga-DOTA-TOC PET/CT was 100% (McNemar, P < 0.5), that of 18F-DOPA PET/CT was 66.7% (McNemar, P < 0.01), that of planar 123I-MIBG imaging was 3.7% (McNemar, P < 0.0001), and that of SPECT/CT was 7.4% (McNemar, P < 0.0001) in HNPGL. Overall, 68Ga-DOTA-TOC PET identified 29 lesions and anatomical imaging identified 27 lesions. 18F-DOPA PET identified 18 lesions, whereas planar 123I-MIBG imaging identified 1 lesion and SPECT/CT 2 lesions.

CONCLUSION: 68Ga-DOTA-TOC PET/CT is superior for imaging, non-malignant and metastatic HNPGL compared to 18F-DOPA PET/CT and planar 123I-MIBG imaging, including SPECT/CT, particularly in bone lesions. Combined functional/anatomical imaging (68Ga-DOTA-TOC PET/CT) enables excellent delineation of tumour extent in these rare tumour entities. Compared to 123I-MIBG scintigraphy, 68Ga-DOTA-TOC PET appears far more useful for planning radionuclide therapy in patients with surgically inoperable tumours or metastatic disease.

Original language	English
Pages (from-to)	47-53
Number of pages	7
Journal	Nuclear Medicine and Biology
Volume	71
DOIs	https://doi.org/10.1016/j.nucmedbio.2019.04.003
Publication status	Published - Apr 2019

Keywords

3-Iodobenzylguanidine
Adult
Aged
Dihydroxyphenylalanine/analogs & derivatives
Female
Head and Neck Neoplasms/diagnostic imaging
Humans
Male
Middle Aged
Octreotide/analogs & derivatives
Organometallic Compounds
Paraganglioma, Extra-Adrenal/diagnostic imaging
Positron Emission Tomography Computed Tomography/methods
Single Photon Emission Computed Tomography Computed Tomography/methods
Ga-DOTA-TOC
Head and neck paraganglioma
F-DOPA
SPECT/CT
I-MIBG
PET

ASJC Scopus subject areas

Molecular Medicine
Radiology, Nuclear Medicine and Imaging
Cancer Research

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10.1016/j.nucmedbio.2019.04.003

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Kroiss, A. S., Uprimny, C., Shulkin, B. L., Gruber, L., Frech, A., Url, C., Riechelmann, H., Sprinzl, G. M., Thomé, C., Treglia, G., Kjaer, A., Fraedrich, G., & Virgolini, I. J. (2019). 68Ga-DOTATOC PET/CT in the localization of head and neck paraganglioma compared with 18F-DOPA PET/CT and 123I-MIBG SPECT/CT. Nuclear Medicine and Biology, 71, 47-53. https://doi.org/10.1016/j.nucmedbio.2019.04.003

@article{64b66ffac21844a8a649b982c216dad4,

title = "68Ga-DOTATOC PET/CT in the localization of head and neck paraganglioma compared with 18F-DOPA PET/CT and 123I-MIBG SPECT/CT",

abstract = "PURPOSE: 18F-Fluoro-L-dihydroxyphenylalanine (18F-DOPA) PET offers high sensitivity and specificity in the imaging of non-malignant head and neck paraganglioma (HNPGL) but lower sensitivity in metastatic disease of these neuroendocrine tumours (NET). In contrast to the radiotracer 18F-DOPA, both 123I-meta-iodo-benzylguanidine (123I-MIBG) and 68Ga-DOTA-Tyr3-octreotide (68Ga-DOTA-TOC) offer valuable clinical information on norepinephrine and somatostatin (SST) receptor status for planning 131I-MIBG and radionuclide peptide therapy (PRRT), respectively. Therefore, we compared 68Ga-DOTA-TOC and 18F-DOPA PET/CT with 123I-MIBG planar and SPECT/CT imaging, for the detection of HNPGL. Combined cross-sectional imaging was the reference standard.METHODS: A total of 3 men and 7 women (age range 22 to 73 years) with anatomical and/or histologically proven HNPGL were included in this study. Of these patients, 3 patients had metastatic HNPGL. Comparative evaluation included morphological imaging with CT and functional imaging with 68Ga-DOTA-TOC and 18F-DOPA PET, including 123I-MIBG imaging. The imaging results were analysed on a per-patient and per-lesion basis.RESULTS: On a per-patient analysis, the detection rate of both 68Ga-DOTA-TOC PET/CT and 18F-DOPA PET/CT was 100%, that of planar 123I-MIBG imaging 10.0% and that of SPECT/CT 20.0%. On a per-lesion basis and in reference to diagnostic CT, the sensitivity of 68Ga-DOTA-TOC PET/CT was 100% (McNemar, P < 0.5), that of 18F-DOPA PET/CT was 66.7% (McNemar, P < 0.01), that of planar 123I-MIBG imaging was 3.7% (McNemar, P < 0.0001), and that of SPECT/CT was 7.4% (McNemar, P < 0.0001) in HNPGL. Overall, 68Ga-DOTA-TOC PET identified 29 lesions and anatomical imaging identified 27 lesions. 18F-DOPA PET identified 18 lesions, whereas planar 123I-MIBG imaging identified 1 lesion and SPECT/CT 2 lesions.CONCLUSION: 68Ga-DOTA-TOC PET/CT is superior for imaging, non-malignant and metastatic HNPGL compared to 18F-DOPA PET/CT and planar 123I-MIBG imaging, including SPECT/CT, particularly in bone lesions. Combined functional/anatomical imaging (68Ga-DOTA-TOC PET/CT) enables excellent delineation of tumour extent in these rare tumour entities. Compared to 123I-MIBG scintigraphy, 68Ga-DOTA-TOC PET appears far more useful for planning radionuclide therapy in patients with surgically inoperable tumours or metastatic disease.",

keywords = "3-Iodobenzylguanidine, Adult, Aged, Dihydroxyphenylalanine/analogs & derivatives, Female, Head and Neck Neoplasms/diagnostic imaging, Humans, Male, Middle Aged, Octreotide/analogs & derivatives, Organometallic Compounds, Paraganglioma, Extra-Adrenal/diagnostic imaging, Positron Emission Tomography Computed Tomography/methods, Single Photon Emission Computed Tomography Computed Tomography/methods, Ga-DOTA-TOC, Head and neck paraganglioma, F-DOPA, SPECT/CT, I-MIBG, PET",

author = "Kroiss, {Alexander Stephan} and Christian Uprimny and Shulkin, {Barry Lynn} and Leonhard Gruber and Andreas Frech and Christoph Url and Herbert Riechelmann and Sprinzl, {Georg Mathias} and Claudius Thom{\'e} and Giorgio Treglia and Andreas Kjaer and Gustav Fraedrich and Virgolini, {Irene Johanna}",

note = "Publisher Copyright: {\textcopyright} 2019 Elsevier Inc.",

year = "2019",

month = apr,

doi = "10.1016/j.nucmedbio.2019.04.003",

language = "English",

volume = "71",

pages = "47--53",

journal = "Nuclear Medicine and Biology",

issn = "0969-8051",

publisher = "Elsevier Inc.",

}

Kroiss, AS, Uprimny, C, Shulkin, BL, Gruber, L, Frech, A, Url, C, Riechelmann, H, Sprinzl, GM, Thomé, C, Treglia, G, Kjaer, A, Fraedrich, G & Virgolini, IJ 2019, '68Ga-DOTATOC PET/CT in the localization of head and neck paraganglioma compared with 18F-DOPA PET/CT and 123I-MIBG SPECT/CT', Nuclear Medicine and Biology, vol. 71, pp. 47-53. https://doi.org/10.1016/j.nucmedbio.2019.04.003

TY - JOUR

T1 - 68Ga-DOTATOC PET/CT in the localization of head and neck paraganglioma compared with 18F-DOPA PET/CT and 123I-MIBG SPECT/CT

AU - Kroiss, Alexander Stephan

AU - Uprimny, Christian

AU - Shulkin, Barry Lynn

AU - Gruber, Leonhard

AU - Frech, Andreas

AU - Url, Christoph

AU - Riechelmann, Herbert

AU - Sprinzl, Georg Mathias

AU - Thomé, Claudius

AU - Treglia, Giorgio

AU - Kjaer, Andreas

AU - Fraedrich, Gustav

AU - Virgolini, Irene Johanna

PY - 2019/4

Y1 - 2019/4

N2 - PURPOSE: 18F-Fluoro-L-dihydroxyphenylalanine (18F-DOPA) PET offers high sensitivity and specificity in the imaging of non-malignant head and neck paraganglioma (HNPGL) but lower sensitivity in metastatic disease of these neuroendocrine tumours (NET). In contrast to the radiotracer 18F-DOPA, both 123I-meta-iodo-benzylguanidine (123I-MIBG) and 68Ga-DOTA-Tyr3-octreotide (68Ga-DOTA-TOC) offer valuable clinical information on norepinephrine and somatostatin (SST) receptor status for planning 131I-MIBG and radionuclide peptide therapy (PRRT), respectively. Therefore, we compared 68Ga-DOTA-TOC and 18F-DOPA PET/CT with 123I-MIBG planar and SPECT/CT imaging, for the detection of HNPGL. Combined cross-sectional imaging was the reference standard.METHODS: A total of 3 men and 7 women (age range 22 to 73 years) with anatomical and/or histologically proven HNPGL were included in this study. Of these patients, 3 patients had metastatic HNPGL. Comparative evaluation included morphological imaging with CT and functional imaging with 68Ga-DOTA-TOC and 18F-DOPA PET, including 123I-MIBG imaging. The imaging results were analysed on a per-patient and per-lesion basis.RESULTS: On a per-patient analysis, the detection rate of both 68Ga-DOTA-TOC PET/CT and 18F-DOPA PET/CT was 100%, that of planar 123I-MIBG imaging 10.0% and that of SPECT/CT 20.0%. On a per-lesion basis and in reference to diagnostic CT, the sensitivity of 68Ga-DOTA-TOC PET/CT was 100% (McNemar, P < 0.5), that of 18F-DOPA PET/CT was 66.7% (McNemar, P < 0.01), that of planar 123I-MIBG imaging was 3.7% (McNemar, P < 0.0001), and that of SPECT/CT was 7.4% (McNemar, P < 0.0001) in HNPGL. Overall, 68Ga-DOTA-TOC PET identified 29 lesions and anatomical imaging identified 27 lesions. 18F-DOPA PET identified 18 lesions, whereas planar 123I-MIBG imaging identified 1 lesion and SPECT/CT 2 lesions.CONCLUSION: 68Ga-DOTA-TOC PET/CT is superior for imaging, non-malignant and metastatic HNPGL compared to 18F-DOPA PET/CT and planar 123I-MIBG imaging, including SPECT/CT, particularly in bone lesions. Combined functional/anatomical imaging (68Ga-DOTA-TOC PET/CT) enables excellent delineation of tumour extent in these rare tumour entities. Compared to 123I-MIBG scintigraphy, 68Ga-DOTA-TOC PET appears far more useful for planning radionuclide therapy in patients with surgically inoperable tumours or metastatic disease.

AB - PURPOSE: 18F-Fluoro-L-dihydroxyphenylalanine (18F-DOPA) PET offers high sensitivity and specificity in the imaging of non-malignant head and neck paraganglioma (HNPGL) but lower sensitivity in metastatic disease of these neuroendocrine tumours (NET). In contrast to the radiotracer 18F-DOPA, both 123I-meta-iodo-benzylguanidine (123I-MIBG) and 68Ga-DOTA-Tyr3-octreotide (68Ga-DOTA-TOC) offer valuable clinical information on norepinephrine and somatostatin (SST) receptor status for planning 131I-MIBG and radionuclide peptide therapy (PRRT), respectively. Therefore, we compared 68Ga-DOTA-TOC and 18F-DOPA PET/CT with 123I-MIBG planar and SPECT/CT imaging, for the detection of HNPGL. Combined cross-sectional imaging was the reference standard.METHODS: A total of 3 men and 7 women (age range 22 to 73 years) with anatomical and/or histologically proven HNPGL were included in this study. Of these patients, 3 patients had metastatic HNPGL. Comparative evaluation included morphological imaging with CT and functional imaging with 68Ga-DOTA-TOC and 18F-DOPA PET, including 123I-MIBG imaging. The imaging results were analysed on a per-patient and per-lesion basis.RESULTS: On a per-patient analysis, the detection rate of both 68Ga-DOTA-TOC PET/CT and 18F-DOPA PET/CT was 100%, that of planar 123I-MIBG imaging 10.0% and that of SPECT/CT 20.0%. On a per-lesion basis and in reference to diagnostic CT, the sensitivity of 68Ga-DOTA-TOC PET/CT was 100% (McNemar, P < 0.5), that of 18F-DOPA PET/CT was 66.7% (McNemar, P < 0.01), that of planar 123I-MIBG imaging was 3.7% (McNemar, P < 0.0001), and that of SPECT/CT was 7.4% (McNemar, P < 0.0001) in HNPGL. Overall, 68Ga-DOTA-TOC PET identified 29 lesions and anatomical imaging identified 27 lesions. 18F-DOPA PET identified 18 lesions, whereas planar 123I-MIBG imaging identified 1 lesion and SPECT/CT 2 lesions.CONCLUSION: 68Ga-DOTA-TOC PET/CT is superior for imaging, non-malignant and metastatic HNPGL compared to 18F-DOPA PET/CT and planar 123I-MIBG imaging, including SPECT/CT, particularly in bone lesions. Combined functional/anatomical imaging (68Ga-DOTA-TOC PET/CT) enables excellent delineation of tumour extent in these rare tumour entities. Compared to 123I-MIBG scintigraphy, 68Ga-DOTA-TOC PET appears far more useful for planning radionuclide therapy in patients with surgically inoperable tumours or metastatic disease.

KW - 3-Iodobenzylguanidine

KW - Adult

KW - Aged

KW - Dihydroxyphenylalanine/analogs & derivatives

KW - Female

KW - Head and Neck Neoplasms/diagnostic imaging

KW - Humans

KW - Male

KW - Middle Aged

KW - Octreotide/analogs & derivatives

KW - Organometallic Compounds

KW - Paraganglioma, Extra-Adrenal/diagnostic imaging

KW - Positron Emission Tomography Computed Tomography/methods

KW - Single Photon Emission Computed Tomography Computed Tomography/methods

KW - Ga-DOTA-TOC

KW - Head and neck paraganglioma

KW - F-DOPA

KW - SPECT/CT

KW - I-MIBG

KW - PET

UR - http://www.scopus.com/inward/record.url?scp=85066109627&partnerID=8YFLogxK

U2 - 10.1016/j.nucmedbio.2019.04.003

DO - 10.1016/j.nucmedbio.2019.04.003

M3 - Journal article

C2 - 31152973

SN - 0969-8051

VL - 71

SP - 47

EP - 53

JO - Nuclear Medicine and Biology

JF - Nuclear Medicine and Biology

ER -

68Ga-DOTATOC PET/CT in the localization of head and neck paraganglioma compared with 18F-DOPA PET/CT and 123I-MIBG SPECT/CT

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