TY - JOUR
T1 - Comparación entre la PET/TC con
18 F-DOPA y la PET/TC con
68 Ga-DOTATOC para la localización del paraganglioma maligno extra-adrenal y el feocromocitoma
AU - Kroiss, A S
AU - Uprimny, C
AU - Shulkin, B L
AU - Gruber, L
AU - Frech, A
AU - Jazbec, T
AU - Girod, P P
AU - Url, C
AU - Thomé, C
AU - Riechelmann, H
AU - Sprinzl, G M
AU - Fraedrich, G
AU - Virgolini, I J
N1 - Publisher Copyright:
© 2018 Sociedad Española de Medicina Nuclear e Imagen Molecular
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Objective:
18 F-Fluoro-L-dihydroxyphenylalanine (
18 F-DOPA) PET offers high sensitivity and specificity in the imaging of non-malignant extra-adrenal paraganglioma (PGL) and pheochromocytoma (PHEO) but lower sensitivity in metastatic disease. These tumours are of neuroendocrine origin and can be detected by
68 Ga-DOTA-Tyr3-octreotide (
68 Ga-DOTA-TOC) PET. Therefore, we compared
68 Ga-DOTA-TOC and
18 F-DOPA as radiolabels for PET/CT imaging for the diagnosis of metastatic extra-adrenal PGL and PHEO. Combined cross-sectional imaging was the reference standard. Methods: A total of 6 men and 4 women (age range 22–72 years) with anatomical and/or histologically proven metastatic PGL and PHEO were included in this study. Of these patients, 2 male patients suffered from PHEO, while the remaining 8 patients were diagnosed as metastatic extra-adrenal PGL disease. Comparative evaluation included morphological imaging with CT and functional imaging with
68 Ga-DOTA-TOC and
18 F-DOPA PET. The imaging results were analyzed on a per-lesion basis. The maximum standardized uptake value (SUV
max ) of each functional imaging modality in concordant tumour lesions was measured. Results: Compared with anatomical imaging, the per-lesion detection rate of
68 Ga-DOTA-TOC was 100% (McNemar, P < 0.01), and that of
18 F-DOPA PET was 82.3% (McNemar, P < 0.8) in metastatic extra-adrenal PGL and PHEO. Overall,
68 Ga-DOTA-TOC PET identified 67 lesions; anatomical imaging identified 62 lesions, and
18 F-DOPA PET identified 56 lesions. The SUV
max (mean ± SD) of all concordant lesions was 29.3 ± 19.9 for
68 Ga-DOTA-TOC PET and 12.3 ± 9.1 for
18 F-DOPA PET (Mann–Whitney U test, P < 0.0001). Conclusion:
68 Ga-DOTA-TOC PET offers the highest detection rate in metastatic extra-adrenal PGL and PHEO compared to
18 F-DOPA PET and even to diagnostic CT, particularly in bone lesions. Combined functional/anatomical imaging (
68 Ga-DOTA-TOC PET/CT) enables exact tumour extension to be detected in these rare tumour entities, especially in the case of unclear anatomical correlation.
AB - Objective:
18 F-Fluoro-L-dihydroxyphenylalanine (
18 F-DOPA) PET offers high sensitivity and specificity in the imaging of non-malignant extra-adrenal paraganglioma (PGL) and pheochromocytoma (PHEO) but lower sensitivity in metastatic disease. These tumours are of neuroendocrine origin and can be detected by
68 Ga-DOTA-Tyr3-octreotide (
68 Ga-DOTA-TOC) PET. Therefore, we compared
68 Ga-DOTA-TOC and
18 F-DOPA as radiolabels for PET/CT imaging for the diagnosis of metastatic extra-adrenal PGL and PHEO. Combined cross-sectional imaging was the reference standard. Methods: A total of 6 men and 4 women (age range 22–72 years) with anatomical and/or histologically proven metastatic PGL and PHEO were included in this study. Of these patients, 2 male patients suffered from PHEO, while the remaining 8 patients were diagnosed as metastatic extra-adrenal PGL disease. Comparative evaluation included morphological imaging with CT and functional imaging with
68 Ga-DOTA-TOC and
18 F-DOPA PET. The imaging results were analyzed on a per-lesion basis. The maximum standardized uptake value (SUV
max ) of each functional imaging modality in concordant tumour lesions was measured. Results: Compared with anatomical imaging, the per-lesion detection rate of
68 Ga-DOTA-TOC was 100% (McNemar, P < 0.01), and that of
18 F-DOPA PET was 82.3% (McNemar, P < 0.8) in metastatic extra-adrenal PGL and PHEO. Overall,
68 Ga-DOTA-TOC PET identified 67 lesions; anatomical imaging identified 62 lesions, and
18 F-DOPA PET identified 56 lesions. The SUV
max (mean ± SD) of all concordant lesions was 29.3 ± 19.9 for
68 Ga-DOTA-TOC PET and 12.3 ± 9.1 for
18 F-DOPA PET (Mann–Whitney U test, P < 0.0001). Conclusion:
68 Ga-DOTA-TOC PET offers the highest detection rate in metastatic extra-adrenal PGL and PHEO compared to
18 F-DOPA PET and even to diagnostic CT, particularly in bone lesions. Combined functional/anatomical imaging (
68 Ga-DOTA-TOC PET/CT) enables exact tumour extension to be detected in these rare tumour entities, especially in the case of unclear anatomical correlation.
KW - Adrenal Gland Neoplasms/diagnostic imaging
KW - Adult
KW - Aged
KW - Dihydroxyphenylalanine/analogs & derivatives
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Organometallic Compounds
KW - Paraganglioma, Extra-Adrenal/diagnostic imaging
KW - Pheochromocytoma/diagnostic imaging
KW - Positron Emission Tomography Computed Tomography/methods
KW - Retrospective Studies
KW - Young Adult
UR - http://www.scopus.com/inward/record.url?scp=85059515896&partnerID=8YFLogxK
U2 - 10.1016/j.remn.2018.09.004
DO - 10.1016/j.remn.2018.09.004
M3 - Artikel in Fachzeitschrift
C2 - 30630744
SN - 2253-8089
VL - 38
SP - 94
EP - 99
JO - Revista espanola de medicina nuclear e imagen molecular
JF - Revista espanola de medicina nuclear e imagen molecular
IS - 2
ER -