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

A S Kroiss, C Uprimny, B L Shulkin, L Gruber, A Frech, T Jazbec, P P Girod, C Url, C Thomé, H Riechelmann, G M Sprinzl, G Fraedrich, I J Virgolini

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

9 Citations (Scopus)

Abstract

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.

Original languageSpanish
Pages (from-to)94-99
Number of pages6
JournalRevista espanola de medicina nuclear e imagen molecular
Volume38
Issue number2
DOIs
Publication statusPublished - 1 Mar 2019

Keywords

  • Adrenal Gland Neoplasms/diagnostic imaging
  • Adult
  • Aged
  • Dihydroxyphenylalanine/analogs & derivatives
  • Female
  • Humans
  • Male
  • Middle Aged
  • Organometallic Compounds
  • Paraganglioma, Extra-Adrenal/diagnostic imaging
  • Pheochromocytoma/diagnostic imaging
  • Positron Emission Tomography Computed Tomography/methods
  • Retrospective Studies
  • Young Adult

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