用 68Ga-DOTA-Tyr3-奥曲肽正电子发射断层扫描和 123I-间碘苄胍对嗜铬细胞瘤和神经母细胞瘤进行功能成像。
Functional imaging in phaeochromocytoma and neuroblastoma with 68Ga-DOTA-Tyr 3-octreotide positron emission tomography and 123I-metaiodobenzylguanidine.
机构信息
Department of Nuclear Medicine, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria.
出版信息
Eur J Nucl Med Mol Imaging. 2011 May;38(5):865-73. doi: 10.1007/s00259-010-1720-x. Epub 2011 Jan 29.
PURPOSE
(68)Ga-DOTA-Tyr(3)-octreotide positron emission tomography ((68)Ga-DOTA-TOC PET) has proven to be superior to (111)In-DTPA-D-Phe(1)-octreotide ((111)In-octreotide) planar scintigraphy and SPECT imaging in neuroendocrine tumours (NETs). Because of these promising results, we compared the accuracy of (123)I-metaiodobenzylguanidine ((123)I-MIBG) imaging with PET in the diagnosis and staging of metastatic phaeochromocytoma and neuroblastoma, referring to radiological imaging as reference standard.
METHODS
Three male and eight female patients (age range 3 to 68 years) with biochemically and histologically proven disease were included in this study. Three male and three female patients were suffering from phaeochromocytoma, and five female patients from neuroblastoma. Comparative evaluation included morphological imaging with CT or MRI, functional imaging with (68)Ga-DOTA-TOC PET and (123)I-MIBG imaging. Imaging results were analysed on a per-patient and on a per-lesion basis.
RESULTS
On a per-patient basis, both (68)Ga-DOTA-TOC and (123)I-MIBG showed a sensitivity of 100%, when compared with anatomical imaging. In phaeochromocytoma patients, on a per-lesion basis, the sensitivity of (68)Ga-DOTA-TOC was 91.7% and that of (123)I-MIBG was 63.3%. In neuroblastoma patients, on a per-lesion basis, the sensitivity of (68)Ga-DOTA-TOC was 97.2% and that of (123)I-MIBG was 90.7%. Overall, in this patient cohort, (68)Ga-DOTA-TOC PET identified 257 lesions, anatomical imaging identified 216 lesions, and (123)I-MIBG identified only 184 lesions. In this patient group, the overall sensitivity of (68)Ga-DOTA-TOC PET on a lesion basis was 94.4% (McNemar p<0.0001) and that of (123)I-MIBG was 76.9% (McNemar p<0.0001).
CONCLUSION
Our analysis in this relatively small patient cohort indicates that (68)Ga-DOTA-TOC PET may be superior to (123)I-MIBG gamma-scintigraphy and even to the reference CT/MRI technique in providing particularly valuable information for pretherapeutic staging of phaeochromocytoma and neuroblastoma.
目的
（68）Ga-DOTA-Tyr（3）-奥曲肽正电子发射断层扫描（（68）Ga-DOTA-TOC PET）已被证明优于神经内分泌肿瘤（NETs）的（111）In-DTPA-D-Phe（1）-奥曲肽（（111）In-octreotide）平面闪烁显像和 SPECT 成像。由于这些有希望的结果，我们比较了（123）I-间碘苄胍（（123）I-MIBG）成像与 PET 在诊断和分期转移性嗜铬细胞瘤和神经母细胞瘤中的准确性，将放射影像学作为参考标准。
方法
本研究纳入了 3 名男性和 8 名女性患者（年龄 3 至 68 岁），这些患者的疾病均经生化和组织学证实。3 名男性和 3 名女性患有嗜铬细胞瘤，5 名女性患有神经母细胞瘤。比较性评估包括 CT 或 MRI 的形态学成像、（68）Ga-DOTA-TOC PET 和（123）I-MIBG 成像的功能成像。对每位患者和每位病变进行成像结果分析。
结果
基于每位患者，（68）Ga-DOTA-TOC 和（123）I-MIBG 与解剖成像相比，其敏感性均为 100%。在嗜铬细胞瘤患者中，基于每位病变，（68）Ga-DOTA-TOC 的敏感性为 91.7%，（123）I-MIBG 的敏感性为 63.3%。在神经母细胞瘤患者中，（68）Ga-DOTA-TOC 的敏感性为 97.2%，（123）I-MIBG 的敏感性为 90.7%。总体而言，在该患者队列中，（68）Ga-DOTA-TOC PET 共发现 257 个病灶，解剖成像发现 216 个病灶，（123）I-MIBG 仅发现 184 个病灶。在该患者组中，（68）Ga-DOTA-TOC PET 在基于病变的基础上的总体敏感性为 94.4%（McNemar p<0.0001），（123）I-MIBG 的敏感性为 76.9%（McNemar p<0.0001）。
结论
我们在相对较小的患者队列中的分析表明，（68）Ga-DOTA-TOC PET 可能优于（123）I-MIBG 伽马闪烁显像，甚至优于参考 CT/MRI 技术，为嗜铬细胞瘤和神经母细胞瘤的治疗前分期提供特别有价值的信息。
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