Rufini V, Treglia G, Castaldi P, Perotti G, Giordano A
Institute of Nuclear Medicine Università Cattolica del Sacro Cuore, Roma, Italy.
Q J Nucl Med Mol Imaging. 2013 Jun;57(2):122-33.
The aim of this paper was to systematically review published data about the comparison of radiolabelled metaiodobenzylguanidine (MIBG) scintigraphy and positron emission tomography (PET) with different radiopharmaceuticals in patients with pheochromocytoma and paraganglioma (Pheo/PGL).
A comprehensive literature search of studies published in PubMed/MEDLINE and Embase databases through September 2012 and regarding MIBG scintigraphy and PET imaging with different radiopharmaceuticals in patients with Pheo/PGL was carried out.
Twenty-eight studies comprising 852 patients who underwent both MIBG scintigraphy and PET or PET/CT with different radiopharmaceuticals were included and discussed. Three studies evaluated carbon-11-hydroxyephedrine ([11C]HED) as PET radiopharmaceutical, nine studies fluorine-18-dopamine ([18F]DA), eight studies fluorine-18-dihydroxyphenylalanine ([18F]DOPA), twelve studies fluorine-18-fluorodeoxyglucose ([18F]FDG) and five studies gallium-68-somatostatin analogues.
Despite the heterogeneity of the studies included in the analysis, it can be concluded that the diagnostic performance of PET with various agents is clearly superior to that of MIBG scintigraphy in patients with Pheo/PGL, mainly for familial, extra-adrenal and metastatic diseases; however, MIBG maintains a unique role in selecting patients suitable for 131I-MBG therapy. Further larger prospective studies comparing MIBG and different PET tracers in patients with Pheo/PGL as well as a cost-effectiveness analysis of the two techniques are needed.
本文旨在系统回顾已发表的关于在嗜铬细胞瘤和副神经节瘤（Pheo/PGL）患者中，放射性标记的间碘苄胍（MIBG）闪烁显像与使用不同放射性药物的正电子发射断层扫描（PET）进行比较的数据。
对截至2012年9月在PubMed/MEDLINE和Embase数据库中发表的、关于Pheo/PGL患者的MIBG闪烁显像以及使用不同放射性药物的PET成像的研究进行了全面的文献检索。
纳入并讨论了28项研究，共852例患者接受了MIBG闪烁显像以及使用不同放射性药物的PET或PET/CT检查。三项研究评估了碳-11-羟基麻黄碱（[11C]HED）作为PET放射性药物，九项研究评估了氟-18-多巴胺（[18F]DA），八项研究评估了氟-18-二羟基苯丙氨酸（[18F]DOPA），十二项研究评估了氟-18-氟脱氧葡萄糖（[18F]FDG），五项研究评估了镓-68-生长抑素类似物。
尽管分析中纳入的研究存在异质性，但可以得出结论，在Pheo/PGL患者中，使用各种药物的PET的诊断性能明显优于MIBG闪烁显像，主要适用于家族性、肾上腺外和转移性疾病；然而，MIBG在选择适合131I-MBG治疗的患者方面仍具有独特作用。需要进一步开展更大规模的前瞻性研究，比较Pheo/PGL患者中MIBG和不同PET示踪剂，并对这两种技术进行成本效益分析。
