(68)Ga-DOTATOC PET/CT provides accurate tumour extent in patients with extraadrenal paraganglioma compared to (123)I-MIBG SPECT/CT

Alexander Kroiss, Barry Lynn Shulkin, Christian Uprimny, Andreas Frech, Rudolf Wolfgang Gasser, Christoph Url, Kurt Gautsch, Ruth Madleitner, Bernhard Nilica, Georg Mathias Sprinzl, Guenther Gastl, Gustav Fraedrich, Irene Johanna Virgolini

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

31 Citations (Scopus)

Abstract

PURPOSE: The aim of this study was to compare the accuracy of (123)I-MIBG SPECT/CT with that of (68)Ga-DOTATOC PET/CT for staging extraadrenal paragangliomas (PGL) using both functional and anatomical images (i.e. combined cross-sectional imaging) as the reference standards.

METHODS: The study included three men and seven women (age range 26 to 73 years) with anatomical and/or histologically proven disease. Three patients had either metastatic head and neck PGL (HNPGL) or multifocal extraadrenal PGL, and seven patients had nonmetastatic extraadrenal disease. Comparative evaluation included morphological imaging with CT, functional imaging with (68)Ga-DOTATOC PET, and (123)I-MIBG imaging. The imaging results were analysed on a per-patient and on a per-lesion basis.

RESULTS: On a per-patient basis, the detection rate of (68)Ga-DOTATOC PET was 100 %, whereas that of planar (123)I-MIBG imaging was 10.0 % and with SPECT/CT 20.0 % for both nonmetastatic and metastatic/multifocal extraadrenal PGL. On a per-lesion basis, the overall sensitivity of (68)Ga-DOTATOC PET was 100 % (McNemar p < 0.5), that of planar (123)I-MIBG imaging was 3.4 % (McNemar p < 0.001) and that of SPECT/CT was 6.9 % (McNemar p < 0.001). Both (68)Ga-DOTATOC PET and anatomical imaging identified 27 lesions. Planar (123)I-MIBG imaging identified only one lesion, and SPECT/CT two lesions. Two additional lesions were detected by (68)Ga-DOTATOC PET but not by either (123)I-MIBG or CT imaging.

CONCLUSION: Our analysis in this patient cohort indicated that (68)Ga-DOTATOC PET/CT is superior to (123)I-MIBG SPECT/CT, particularly in head and neck and bone lesions, and provides valuable information for staging extraadrenal PGL, particularly in patients with surgically inoperable tumours or multifocal/malignant disease.

Original languageEnglish
Pages (from-to)33-41
Number of pages9
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume42
Issue number1
DOIs
Publication statusPublished - 26 Nov 2015

Keywords

  • 3-Iodobenzylguanidine
  • Adult
  • Aged
  • Female
  • Head and Neck Neoplasms/diagnostic imaging
  • Humans
  • Male
  • Middle Aged
  • Multimodal Imaging/standards
  • Octreotide/analogs & derivatives
  • Organometallic Compounds
  • Paraganglioma, Extra-Adrenal/diagnostic imaging
  • Positron-Emission Tomography/standards
  • Radiopharmaceuticals
  • Reference Standards
  • Sensitivity and Specificity
  • Tomography, Emission-Computed, Single-Photon/standards
  • Tomography, X-Ray Computed/standards

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