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

15 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

Cite this

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 - https://www.scopus.com/pages/publications/85066109627

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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Keywords

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