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- Title
Prospective comparison of Ga-DOTATATE and F-FDOPA PET/CT in patients with various pheochromocytomas and paragangliomas with emphasis on sporadic cases.
- Authors
Archier, Aurélien; Varoquaux, Arthur; Garrigue, Philippe; Montava, Marion; Guerin, Carole; Gabriel, Sophie; Beschmout, Eva; Morange, Isabelle; Fakhry, Nicolas; Castinetti, Frédéric; Sebag, Frédéric; Barlier, Anne; Loundou, Anderson; Guillet, Benjamin; Pacak, Karel; Taïeb, David
- Abstract
Purpose: Pheochromocytomas/paragangliomas (PHEOs/PGLs) overexpress somatostatin receptors and recent studies have already shown excellent results in the localization of these tumors using Ga-labeled somatostatin analogs (Ga-DOTA-SSA), especially in patients with germline succinate dehydrogenase subunit B gene ( SDHB) mutations and head and neck PGLs (HNPGLs). The value of Ga-DOTA-SSA has to be established in sporadic cases, including PHEOs. Thus, the aim of this study was to compare Ga-DOTATATE PET/CT, F-FDOPA PET/CT, and conventional imaging in patients with various PHEOs/PGLs with a special emphasis on sporadic cases, including those located in the adrenal gland. Design: Ga-DOTATATE, F-FDOPA PET/CT, and conventional imaging (contrast-enhanced CT and MRI with MR angiography sequences) were prospectively performed in 30 patients (8 with SDHD mutations, 1 with a MAX mutation and 21 sporadic cases) with PHEO/PGL at initial diagnosis or relapse. Results: The patient-based sensitivities were 93 % (28/30), 97 % (29/30), and 93 % (28/30) for Ga-DOTATATE PET/CT, F-FDOPA PET/CT, and conventional imaging, respectively. The lesion-based sensitivities were 93 % (43/46), 89 % (41/46), and 76 % (35/46) for Ga-DOTATATE PET/CT, F-FDOPA PET/CT, and conventional imaging respectively ( p = 0.042). Ga-DOTATATE PET/CT detected a higher number of HNPGLs (30/30) than F-FDOPA PET/CT (26/30; p = 0.112) and conventional imaging (24/30; p = 0.024). Ga-DOTATATE PET/CT missed two PHEOs of a few millimeters in size and a large recurrent PHEO. One lesion was considered false-positive on Ga-DOTATATE PET/CT and corresponded to a typical focal lesion of fibrous dysplasia on MRI. Among the 11 lesions missed by conventional imaging, 7 were detected by conventional imaging with knowledge of the PET results (4 HNPGLs, 2 LNs, and 1 recurrent PHEO). Conclusion: Ga-DOTATATE PET/CT is the most sensitive tool in the detection of HNPGLs, especially SDHD-related tumors, which may be very small and fail to concentrate sufficient F-FDOPA. The present study further expands the use of Ga-DOTATATE for all patients with HNPGLs, regardless of their genotype. Ga-DOTATATE PET/CT may be inferior to F-FDOPA PET/CT in the detection PHEOs.
- Subjects
POSITRON emission tomography; DIAGNOSTIC imaging research; SOMATOSTATIN; GALLIUM; PHEOCHROMOCYTOMA; PARAGANGLIOMA; DIAGNOSIS
- Publication
European Journal of Nuclear Medicine & Molecular Imaging, 2016, Vol 43, Issue 7, p1248
- ISSN
1619-7070
- Publication type
Article
- DOI
10.1007/s00259-015-3268-2