Nucl Med Mol Imaging.  2015 Jun;49(2):143-151. 10.1007/s13139-015-0331-7.

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

• Tan TH
• Hussein Z
• Saad FF
• Shuaib IL

• KMID: 2313261
• DOI: http://doi.org/10.1007/s13139-015-0331-7

Abstract

PURPOSE
To evaluate the diagnostic performance of 68Ga-DOTATATE 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT), 18F-FDGPET/CTand 131I-MIBG scintigraphy in themapping 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 68Ga-DOTATATE and 131I-MIBG without 18F-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 68Ga-DOTATATE, 7/17 patients in 131I-MIBG, and 10/12 patients in 18F-FDG. The sensitivity and accuracy of 68Ga-DOTATATE, 131I-MIBG and 18F-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 68Ga-DOTATA TE, 74/472 by 131I-MIBG, and 154/300 (patient, n=12) by 18F-FDG. The sensitivity and accuracy of 68Ga-DOTATATE, 131I-MIBG and 18F-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 68Ga-DOTATATE, 131I-MIBG and 18F-FDG.
CONCLUSIONS
Ga-DOTATATE PET/CT shows high diagnostic accuracy than 131I-MIBG scintigraphy and 18F-FDG PET/ CT in mapping metastatic pheochromocytoma and paraganglioma.

Keyword

68Ga-DOTATATE; 18F-FDG; 131I-MIBG; PET/CT; Pheochromocytoma; Paraganglioma

MeSH Terms

Fluorodeoxyglucose F18*
Humans
Paraganglioma*
Pheochromocytoma*
Positron-Emission Tomography
Positron-Emission Tomography and Computed Tomography*
Prospective Studies
Radionuclide Imaging*
Fluorodeoxyglucose F18