68Ga-DOTA-TOC PET/CT 与 18F-DOPA PET/CT 对肾上腺外副神经节瘤的回顾性比较。
A retrospective comparison between 68Ga-DOTA-TOC PET/CT and 18F-DOPA PET/CT in patients with extra-adrenal paraganglioma.
机构信息
Department of Nuclear Medicine, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria,
出版信息
Eur J Nucl Med Mol Imaging. 2013 Dec;40(12):1800-8. doi: 10.1007/s00259-013-2548-y. Epub 2013 Sep 27.
PURPOSE
(18)F-Fluoro-L-dihydroxyphenylalanine ((18)F-DOPA) PET offers high sensitivity and specificity in the imaging of nonmetastatic extra-adrenal paragangliomas (PGL) but lower sensitivity in metastatic or multifocal disease. These tumours are of neuroendocrine origin and can be detected by (68)Ga-DOTA-Tyr(3)-octreotide ((68)Ga-DOTA-TOC) PET. Therefore, we compared (68)Ga-DOTA-TOC and (18)F-DOPA as radiolabels for PET/CT imaging for the diagnosis and staging of extra-adrenal PGL. Combined cross-sectional imaging was the reference standard.
METHODS
A total of 5 men and 15 women (age range 22 to 73 years) with anatomical and/or histologically proven extra-adrenal PGL were included in this study. Of these patients, 5 had metastatic or multifocal lesions and 15 had single sites of disease. Comparative evaluation included morphological imaging with CT and functional imaging with (68)Ga-DOTA-TOC PET and (18)F-DOPA PET. The imaging results were analysed on a per-patient and a per-lesion basis. The maximum standardized uptake value (SUVmax) of each functional imaging modality in concordant tumour lesions was measured.
RESULTS
Compared with anatomical imaging, (68)Ga-DOTA-TOC PET and (18)F-DOPA PET each had a per-patient and per-lesion detection rate of 100% in nonmetastatic extra-adrenal PGL. However, in metastatic or multifocal disease, the per-lesion detection rate of (68)Ga-DOTA-TOC was 100% and that of (18)F-DOPA PET was 56.0%. Overall, (68)Ga-DOTA-TOC PET identified 45 lesions; anatomical imaging identified 43 lesions, and (18)F-DOPA PET identified 32 lesions. The overall per-lesion detection rate of (68)Ga-DOTA-TOC PET was 100% (McNemar, P < 0.5), and that of (18)F-DOPA PET was 71.1% (McNemar, P < 0.001). The SUVmax (mean ± SD) of all 32 concordant lesions was 67.9 ± 61.5 for (68)Ga-DOTA-TOC PET and 11.8 ± 7.9 for (18)F-DOPA PET (Mann-Whitney U test, P < 0.0001).
CONCLUSION
(68)Ga-DOTA-TOC PET may be superior to (18)F-DOPA PET and diagnostic CT in providing valuable information for pretherapeutic staging of extra-adrenal PGL, particularly in surgically inoperable tumours and metastatic or multifocal disease.
目的
（18）F-氟代-L-二羟苯丙氨酸（（18）F-DOPA）PET 在非肾上腺嗜铬细胞瘤（PGL）的非转移性病变的成像中具有较高的灵敏度和特异性，但在转移性或多灶性病变中灵敏度较低。这些肿瘤来源于神经内分泌，可通过（68）Ga-二肽基-苯丙氨酸（3）-正电子发射断层扫描（（68）Ga-DOTA-Tyr（3）-奥曲肽）（68）Ga-DOTA-TOC）PET 检测到。因此，我们比较了（68）Ga-DOTA-TOC 和（18）F-DOPA 作为 PET/CT 成像的放射性示踪剂，用于诊断和分期非肾上腺 PGL。联合横断面成像为参考标准。
方法
本研究共纳入 5 名男性和 15 名女性（年龄 22 至 73 岁），经解剖学和/或组织学证实患有非肾上腺 PGL。这些患者中，5 例有转移性或多灶性病变，15 例有单发病灶。比较性评估包括 CT 形态学成像和（68）Ga-DOTA-TOC PET 和（18）F-DOPA PET 的功能成像。根据患者和病变分别对成像结果进行分析。测量每种功能成像方法在一致性肿瘤病变中的最大标准化摄取值（SUVmax）。
结果
与解剖学成像相比，（68）Ga-DOTA-TOC PET 和（18）F-DOPA PET 在非转移性非肾上腺 PGL 中，对每位患者和每个病变的检测率均为 100%。然而，在转移性或多灶性病变中，（68）Ga-DOTA-TOC 的每个病变的检测率为 100%，（18）F-DOPA PET 的检测率为 56.0%。总体而言，（68）Ga-DOTA-TOC PET 检出 45 个病灶；解剖学成像检出 43 个病灶，（18）F-DOPA PET 检出 32 个病灶。（68）Ga-DOTA-TOC PET 的整体病变检出率为 100%（McNemar，P<0.5），（18）F-DOPA PET 的病变检出率为 71.1%（McNemar，P<0.001）。所有 32 个一致性病变的 SUVmax（平均值±标准差）为（68）Ga-DOTA-TOC PET 为 67.9±61.5，（18）F-DOPA PET 为 11.8±7.9（Mann-Whitney U 检验，P<0.0001）。
结论
（68）Ga-DOTA-TOC PET 可能优于（18）F-DOPA PET 和诊断 CT，在提供非肾上腺嗜铬细胞瘤术前分期的有价值信息方面具有优势，尤其是在手术不可切除的肿瘤和转移性或多灶性病变中。
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