Diagnostic Performance of (68)Ga-DOTATATE PET/CT, (18)F-FDG PET/CT and (131)I-MIBG Scintigraphy in Mapping Metastatic Pheochromocytoma and Paraganglioma

Overview

Journal Nucl Med Mol Imaging

Publisher Springer

Date 2015 Jun 19

PMID 26085860

Citations 26

Authors

Teik Hin Tan

Zanariah Hussein

Fathinul Fikri Ahmad Saad

Ibrahim Lutfi Shuaib

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the diagnostic performance of (68)Ga-DOTATATE (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET)/computed tomography (CT), (18)F-FDG PET/CT and (131)I-MIBG scintigraphy in the mapping of metastatic pheochromocytoma and paraganglioma.

Materials And Methods: Seventeen patients (male = 8, female = 9; age range, 13-68 years) with clinically proven or suspicious metastatic pheochromocytoma or paraganglioma were included in this prospective study. Twelve patients underwent all three modalities, whereas five patients underwent (68)Ga-DOTATATE and (131)I-MIBG without (18)F-FDG. A composite reference standard derived from anatomical and functional imaging findings, along with histopathological information, was used to validate the findings. Results were analysed on a per-patient and on per-lesion basis. Sensitivity and accuracy were assessed using McNemar's test.

Results: On a per-patient basis, 14/17 patients were detected in (68)Ga-DOTATATE, 7/17 patients in (131)I-MIBG, and 10/12 patients in (18)F-FDG. The sensitivity and accuracy of (68)Ga-DOTATATE, (131)I-MIBG and (18)F-FDG were (93.3 %, 94.1 %), (46.7 %, 52.9 %) and (90.9 %, 91.7 %) respectively. On a per-lesion basis, an overall of 472 positive lesions were detected; of which 432/472 were identified by (68)Ga-DOTATATE, 74/472 by (131)I-MIBG, and 154/300 (patient, n = 12) by (18)F-FDG. The sensitivity and accuracy of (68)Ga-DOTATATE, (131)I-MIBG and (18)F-FDG were (91.5 %, 92.6 % p < 0.0001), (15.7 %, 26.0 % p < 0.0001) and (51.3 %, 57.8 % p < 0.0001) respectively. Discordant lesions were demonstrated on (68)Ga-DOTATATE, (131)I-MIBG and (18)F-FDG.

Conclusions: Ga-DOTATATE PET/CT shows high diagnostic accuracy than (131)I-MIBG scintigraphy and (18)F-FDG PET/ CT in mapping metastatic pheochromocytoma and paraganglioma.

Citing Articles

Perspective review: lessons from successful clinical trials and real-world studies of systemic therapy for metastatic pheochromocytomas and paragangliomas.

Jimenez C, Baudrand R, Uslar T, Bulzico D Ther Adv Med Oncol. 2024; 16:17588359241301359.

PMID: 39574494 PMC: 11580098. DOI: 10.1177/17588359241301359.

Imaging of Pheochromocytomas and Paragangliomas.

Timmers H, Taieb D, Pacak K, Lenders J Endocr Rev. 2024; 45(3):414-434.

PMID: 38206185 PMC: 11074798. DOI: 10.1210/endrev/bnae001.

Effectiveness of F-FDG PET/CT in finding lung metastasis from a retroperitoneal paraganglioma.

Chikasue T, Kurata S, Nagata S, Tanoue S, Sumi A, Gobaru M Asia Ocean J Nucl Med Biol. 2024; 12(1):46-51.

PMID: 38164231 PMC: 10757060. DOI: 10.22038/AOJNMB.2023.74066.1516.

A Prospective Comparative Study of 18 F-FDOPA PET/CT Versus 123 I-MIBG Scintigraphy With SPECT/CT for the Diagnosis of Pheochromocytoma and Paraganglioma.

Sung C, Lee H, Lee D, Kim Y, Kim J, Lee S Clin Nucl Med. 2023; 49(1):27-36.

PMID: 38054497 PMC: 11805481. DOI: 10.1097/RLU.0000000000004963.

Synchronous carotid body and anterior mediastinal paraganglioma revealed by F-fluorodeoxyglucose and Ga-DOTA(0)-Tyr(3)-octreotate positron emission tomography-computed tomography.

Xie H, Lin H, Li L, Zhang W Quant Imaging Med Surg. 2023; 13(6):4007-4014.

PMID: 37284100 PMC: 10240021. DOI: 10.21037/qims-22-1018.

References

Oh S, Prasad V, Lee D, Baum R . Effect of Peptide Receptor Radionuclide Therapy on Somatostatin Receptor Status and Glucose Metabolism in Neuroendocrine Tumors: Intraindividual Comparison of Ga-68 DOTANOC PET/CT and F-18 FDG PET/CT. Int J Mol Imaging. 2011; 2011:524130. PMC: 3216394. DOI: 10.1155/2011/524130. View

Korevaar T, Grossman A . Pheochromocytomas and paragangliomas: assessment of malignant potential. Endocrine. 2011; 40(3):354-65. DOI: 10.1007/s12020-011-9545-3. View

Taieb D, Rubello D, Al-Nahhas A, Calzada M, Marzola M, Hindie E . Modern PET imaging for paragangliomas: relation to genetic mutations. Eur J Surg Oncol. 2011; 37(8):662-8. DOI: 10.1016/j.ejso.2011.05.004. View

Havekes B, King K, Lai E, Romijn J, Corssmit E, Pacak K . New imaging approaches to phaeochromocytomas and paragangliomas. Clin Endocrinol (Oxf). 2009; 72(2):137-45. PMC: 2966973. DOI: 10.1111/j.1365-2265.2009.03648.x. View

van der Harst E, de Herder W, Bruining H, Bonjer H, de Krijger R, Lamberts S . [(123)I]metaiodobenzylguanidine and [(111)In]octreotide uptake in begnign and malignant pheochromocytomas. J Clin Endocrinol Metab. 2001; 86(2):685-93. DOI: 10.1210/jcem.86.2.7238. View

Tenenbaum F, Lumbroso J, Schlumberger M, MURE A, Plouin P, Caillou B . Comparison of radiolabeled octreotide and meta-iodobenzylguanidine (MIBG) scintigraphy in malignant pheochromocytoma. J Nucl Med. 1995; 36(1):1-6. View

Wiseman G, Pacak K, ODorisio M, Neumann D, Waxman A, Mankoff D . Usefulness of 123I-MIBG scintigraphy in the evaluation of patients with known or suspected primary or metastatic pheochromocytoma or paraganglioma: results from a prospective multicenter trial. J Nucl Med. 2009; 50(9):1448-54. PMC: 4722807. DOI: 10.2967/jnumed.108.058701. View

Koopmans K, Jager P, Kema I, Kerstens M, Albers F, Dullaart R . 111In-octreotide is superior to 123I-metaiodobenzylguanidine for scintigraphic detection of head and neck paragangliomas. J Nucl Med. 2008; 49(8):1232-7. DOI: 10.2967/jnumed.107.047738. View

Naji M, Zhao C, Welsh S, Meades R, Win Z, Ferrarese A . 68Ga-DOTA-TATE PET vs. 123I-MIBG in identifying malignant neural crest tumours. Mol Imaging Biol. 2010; 13(4):769-75. DOI: 10.1007/s11307-010-0396-8. View

10.

Harari A, Inabnet 3rd W . Malignant pheochromocytoma: a review. Am J Surg. 2010; 201(5):700-8. DOI: 10.1016/j.amjsurg.2010.04.012. View

11.

Gabriel M, Decristoforo C, Kendler D, Dobrozemsky G, Heute D, Uprimny C . 68Ga-DOTA-Tyr3-octreotide PET in neuroendocrine tumors: comparison with somatostatin receptor scintigraphy and CT. J Nucl Med. 2007; 48(4):508-18. DOI: 10.2967/jnumed.106.035667. View

12.

Sharma P, Dhull V, Jeph S, Reddy R, Singh H, Naswa N . Can hybrid SPECT-CT overcome the limitations associated with poor imaging properties of 131I-MIBG?: Comparison with planar scintigraphy and SPECT in pheochromocytoma. Clin Nucl Med. 2013; 38(9):e346-53. DOI: 10.1097/RLU.0b013e318279bcb2. View

13.

Krausz Y, Freedman N, Rubinstein R, Lavie E, Orevi M, Tshori S . 68Ga-DOTA-NOC PET/CT imaging of neuroendocrine tumors: comparison with ¹¹¹In-DTPA-octreotide (OctreoScan®). Mol Imaging Biol. 2010; 13(3):583-593. DOI: 10.1007/s11307-010-0374-1. View

14.

Mundschenk J, Unger N, Schulz S, Hollt V, Schulz S, Steinke R . Somatostatin receptor subtypes in human pheochromocytoma: subcellular expression pattern and functional relevance for octreotide scintigraphy. J Clin Endocrinol Metab. 2003; 88(11):5150-7. DOI: 10.1210/jc.2003-030262. View

15.

Amar L, Baudin E, Burnichon N, Peyrard S, Silvera S, Bertherat J . Succinate dehydrogenase B gene mutations predict survival in patients with malignant pheochromocytomas or paragangliomas. J Clin Endocrinol Metab. 2007; 92(10):3822-8. DOI: 10.1210/jc.2007-0709. View

16.

Maecke H, Reubi J . Somatostatin receptors as targets for nuclear medicine imaging and radionuclide treatment. J Nucl Med. 2011; 52(6):841-4. DOI: 10.2967/jnumed.110.084236. View

17.

Wahl R, Jacene H, Kasamon Y, Lodge M . From RECIST to PERCIST: Evolving Considerations for PET response criteria in solid tumors. J Nucl Med. 2009; 50 Suppl 1:122S-50S. PMC: 2755245. DOI: 10.2967/jnumed.108.057307. View

18.

Kayani I, Conry B, Groves A, Win T, Dickson J, Caplin M . A comparison of 68Ga-DOTATATE and 18F-FDG PET/CT in pulmonary neuroendocrine tumors. J Nucl Med. 2009; 50(12):1927-32. DOI: 10.2967/jnumed.109.066639. View

19.

Agarwal A, Mehrotra P, Jain M, Gupta S, Mishra A, Chand G . Size of the tumor and pheochromocytoma of the adrenal gland scaled score (PASS): can they predict malignancy?. World J Surg. 2010; 34(12):3022-8. DOI: 10.1007/s00268-010-0744-5. View

20.

Sharma P, Dhull V, Arora S, Gupta P, Kumar R, Durgapal P . Diagnostic accuracy of (68)Ga-DOTANOC PET/CT imaging in pheochromocytoma. Eur J Nucl Med Mol Imaging. 2013; 41(3):494-504. DOI: 10.1007/s00259-013-2598-1. View