Janssen Ingo, Blanchet Elise M, Adams Karen, Chen Clara C, Millo Corina M, Herscovitch Peter, Taieb David, Kebebew Electron, Lehnert Hendrik, Fojo Antonio T, Pacak Karel
Program in Adult and Reproductive Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, Maryland. Department of Radiology and Nuclear Medicine, Section of Nuclear Medicine, University Hospital Schleswig Holstein, Campus Lübeck, Lübeck, Germany.
Nuclear Medicine Department, Bichat Hospital, Paris, France.
Clin Cancer Res. 2015 Sep 1;21(17):3888-95. doi: 10.1158/1078-0432.CCR-14-2751. Epub 2015 Apr 14.
Patients with succinate dehydrogenase subunit B(SDHB) mutation-related pheochromocytoma/paraganglioma (PHEO/PGL) are at a higher risk for metastatic disease than other hereditary PHEOs/PGLs. Current therapeutic approaches are limited, but the best outcomes are based on the early and proper detection of as many lesions as possible. Because PHEOs/PGLs overexpress somatostatin receptor 2 (SSTR2), the goal of our study was to assess the clinical utility of [(68)Ga]-DOTA(0)-Tyr(3)-octreotate ([(68)Ga]-DOTATATE) positron emission tomography/computed tomography (PET/CT) and to evaluate its diagnostic utility in comparison with the currently recommended functional imaging modalities [(18)F]-fluorodopamine ([(18)F]-FDA), [(18)F]-fluorodihydroxyphenylalanine ([(18)F]-FDOPA), [(18)F]-fluoro-2-deoxy-d-glucose ([(18)F]- FDG) PET/CT as well as CT/MRI.
[(68)Ga]-DOTATATE PET/CT was prospectively performed in 17 patients with SDHB-related metastatic PHEOs/PGLs. All patients also underwent [(18)F]-FDG PET/CT and CT/MRI, with 16 of the 17 patients also receiving [(18)F]-FDOPA and [(18)F]-FDA PET/CT scans. Detection rates of metastatic lesions were compared between all these functional imaging studies. A composite synthesis of all used functional and anatomical imaging studies served as the imaging comparator.
[(68)Ga]-DOTATATE PET/CT demonstrated a lesion-based detection rate of 98.6% [95% confidence interval (CI), 96.5%-99.5%], [(18)F]-FDG, [(18)F]-FDOPA, [(18)F]-FDA PET/CT, and CT/MRI showed detection rates of 85.8% (CI, 81.3%-89.4%; P < 0.01), 61.4% (CI, 55.6%-66.9%; P < 0.01), 51.9% (CI, 46.1%-57.7%; P < 0.01), and 84.8% (CI, 80.0%-88.5%; P < 0.01), respectively.
[(68)Ga]-DOTATATE PET/CT showed a significantly superior detection rate to all other functional and anatomical imaging modalities and may represent the preferred future imaging modality in the evaluation of SDHB-related metastatic PHEO/PGL.
与琥珀酸脱氢酶亚基B（SDHB）突变相关的嗜铬细胞瘤/副神经节瘤（PHEO/PGL）患者发生转移性疾病的风险高于其他遗传性PHEO/PGL。目前的治疗方法有限，但最佳治疗效果取决于尽早且尽可能多地检测出病变。由于PHEO/PGL过度表达生长抑素受体2（SSTR2），我们研究的目的是评估[（68）Ga] - DOTA（0）-Tyr（3）-奥曲肽（[（68）Ga] - DOTATATE）正电子发射断层扫描/计算机断层扫描（PET/CT）的临床实用性，并与目前推荐的功能成像模式[（18）F] - 氟多巴胺（[（18）F] - FDA）、[（18）F] - 氟二羟基苯丙氨酸（[（18）F] - FDOPA）、[（18）F] - 氟 - 2 - 脱氧 - D - 葡萄糖（[（18）F] - FDG）PET/CT以及CT/MRI相比较，评估其诊断实用性。
对17例与SDHB相关的转移性PHEO/PGL患者前瞻性地进行了[（68）Ga] - DOTATATE PET/CT检查。所有患者还接受了[（18）F] - FDG PET/CT和CT/MRI检查，17例患者中有16例还接受了[（18）F] - FDOPA和[（18）F] - FDA PET/CT扫描。比较了所有这些功能成像研究中转移性病变的检出率。将所有使用的功能和解剖成像研究进行综合合成作为成像对照。
[（68）Ga] - DOTATATE PET/CT显示基于病变的检出率为98.6% [95%置信区间（CI），96.5% - 99.5%]，[（18）F] - FDG、[（18）F] - FDOPA、[（18）F] - FDA PET/CT以及CT/MRI的检出率分别为85.8%（CI，81.3% - 89.4%；P < 0.01）、61.4%（CI，并为55.6% - 66.9%；P < 0.01）、51.9%（CI，46.1% - 57.7%；P < 0.01）和84.8%（CI，80.0% - 88.5%；P < 0.01）。
[（68）Ga] - DOTATATE PET/CT显示出比所有其他功能和解剖成像模式显著更高的检出率，可能是未来评估与SDHB相关的转移性PHEO/PGL的首选成像模式。
