SDHx 相关头颈部副神经节瘤的功能影像学：18F-氟多巴、18F-氟去氧葡萄糖 PET、123I-间碘苄胍闪烁显像和 111In-喷替酸五肽闪烁显像的比较。
Functional imaging of SDHx-related head and neck paragangliomas: comparison of 18F-fluorodihydroxyphenylalanine, 18F-fluorodopamine, 18F-fluoro-2-deoxy-D-glucose PET, 123I-metaiodobenzylguanidine scintigraphy, and 111In-pentetreotide scintigraphy.
机构信息
Reproductive and Adult Endocrinology Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, National Institutes of Health, Bethesda, Maryland 20892, USA.
出版信息
J Clin Endocrinol Metab. 2011 Sep;96(9):2779-85. doi: 10.1210/jc.2011-0333. Epub 2011 Jul 13.
RATIONALE
Accurate diagnosis of head and neck paragangliomas is often complicated by biochemical silence and lack of catecholamine-associated symptoms, making accurate anatomical and functional imaging techniques essential to the diagnostic process.
METHODS
Ten patients (seven SDHD, three SDHB), with a total of 26 head and neck paragangliomas, were evaluated with anatomical and functional imaging. This study compares five different functional imaging techniques [(18)F-fluorodihydroxyphenylalanine ((18)F-FDOPA) positron emission tomography (PET), (18)F-fluorodopamine ((18)F-FDA) PET/computed tomography (CT), (18)F-fluoro-2-deoxy-D-glucose ((18)F-FDG) PET/CT, (123)I-metaiodobenzylguanidine ((123)I-MIBG) scintigraphy, and (111)In-pentetreotide scintigraphy] in the localization of head and neck paragangliomas.
RESULTS
Prospectively (18)F-FDOPA PET localized 26 of 26 lesions in the 10 patients, CT/magnetic resonance imaging localized 21 of 26 lesions, (18)F-FDG PET/CT localized 20 of 26 lesions, (111)In-pentetreotide scintigraphy localized 16 of 25 lesions, (18)F-FDA PET/CT localized 12 of 26 lesions, and (123)I-MIBG scintigraphy localized eight of 26 lesions. Differences in imaging efficacy related to genetic phenotype, even in the present small sample size, included the negativity of (18)F-FDA PET/CT and (123)I-MIBG scintigraphy in patients with SDHB mutations and the accuracy of (18)F-FDG PET/CT in all patients with SDHD mutations, as compared with the accuracy of (18)F-FDG PET/CT in only one patient with an SDHB mutation.
CONCLUSION
Overall, (18)F-FDOPA PET proved to be the most efficacious functional imaging modality in the localization of SDHx-related head and neck paragangliomas and may be a potential first-line functional imaging agent for the localization of these tumors.
背景
由于生化无活性和缺乏儿茶酚胺相关症状，头颈部副神经节瘤的准确诊断常常变得复杂，因此准确的解剖学和功能成像技术对于诊断过程至关重要。
方法
评估了 10 例（7 例 SDHD，3 例 SDHB）共 26 例头颈部副神经节瘤患者的解剖学和功能影像学。本研究比较了 5 种不同的功能成像技术[（18）F-氟代二羟苯丙氨酸（（18）F-FDOPA）正电子发射断层扫描（PET）、（18）F-氟代多巴胺（（18）F-FDA）PET/计算机断层扫描（CT）、（18）F-氟代脱氧葡萄糖（（18）F-FDG）PET/CT、（123）I-间碘苄胍（（123）I-MIBG）闪烁显像和（111）In-喷曲肽闪烁显像]对头颈部副神经节瘤的定位。
结果
前瞻性（18）F-FDOPA PET 定位了 10 例患者中的 26 例病变，CT/MRI 定位了 21 例病变，（18）F-FDG PET/CT 定位了 20 例病变，（111）In-喷曲肽闪烁显像定位了 25 例病变中的 16 例，（18）F-FDA PET/CT 定位了 26 例病变中的 12 例，（123）I-MIBG 闪烁显像定位了 26 例病变中的 8 例。与遗传表型相关的成像效果差异，即使在目前的小样本量中，也包括 SDHB 突变患者中（18）F-FDA PET/CT 和（123）I-MIBG 闪烁显像的阴性以及 SDHD 突变患者中（18）F-FDG PET/CT 的准确性，而在 SDHB 突变患者中仅 1 例准确性为（18）F-FDG PET/CT。
结论
总的来说，（18）F-FDOPA PET 在定位 SDHx 相关头颈部副神经节瘤方面被证明是最有效的功能成像方式，并且可能是定位这些肿瘤的潜在一线功能成像剂。
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