Janssen Ingo, Chen Clara C, Taieb David, Patronas Nicholas J, Millo Corina M, Adams Karen T, Nambuba Joan, Herscovitch Peter, Sadowski Samira M, Fojo Antonio T, Buchmann Inga, Kebebew Electron, Pacak Karel
Program in Adult and Reproductive Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland Section of Nuclear Medicine, Department of Radiology and Nuclear Medicine, University Hospital Schleswig Holstein, Lübeck, Germany.
Nuclear Medicine Division, Radiology & Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland.
J Nucl Med. 2016 Feb;57(2):186-91. doi: 10.2967/jnumed.115.161018. Epub 2015 Nov 12.
Pheochromocytomas/paragangliomas overexpress somatostatin receptors, and recent studies have already shown excellent results in the localization of sympathetic succinate dehydrogenase complex, subunit B, mutation-related metastatic pheochromocytomas/paragangliomas using (68)Ga-DOTATATE PET/CT. Therefore, the goal of our study was to assess the clinical utility of this functional imaging modality in parasympathetic head and neck paragangliomas (HNPGLs) compared with anatomic imaging with CT/MRI and other functional imaging modalities, including (18)F-fluorohydroyphenylalanine ((18)F-FDOPA) PET/CT, currently the gold standard in the functional imaging of HNPGLs.
(68)Ga-DOTATATE PET/CT was prospectively performed in 20 patients with HNPGLs. All patients also underwent (18)F-FDOPA PET/CT, (18)F-FDG PET/CT, and CT/MRI, with 18 patients also undergoing (18)F-fluorodopamine ((18)F-FDA) PET/CT. (18)F-FDOPA PET/CT and CT/MRI served as the imaging comparators.
Thirty-eight lesions in 20 patients were detected, with (18)F-FDOPA PET/CT identifying 37 of 38 and CT/MRI identifying 23 of 38 lesions (P < 0.01). All 38 and an additional 7 lesions (P = 0.016) were detected on (68)Ga-DOTATATE PET/CT. Significantly fewer lesions were identified by (18)F-FDG PET/CT (24/38, P < 0.01) and (18)F-FDA PET/CT (10/34, P < 0.01).
(68)Ga-DOTATATE PET/CT identified more lesions than other imaging modalities. With the results of the present study, and the increasing availability and use of DOTA analogs in the therapy of neuroendocrine tumors, we expect that (68)Ga-DOTATATE PET/CT will become the preferred functional imaging modality for HNPGLs in the near future.
嗜铬细胞瘤/副神经节瘤过度表达生长抑素受体，近期研究已显示，使用（68）Ga-DOTATATE PET/CT在定位与琥珀酸脱氢酶复合物B亚基突变相关的转移性嗜铬细胞瘤/副神经节瘤方面取得了优异成果。因此，我们研究的目的是评估这种功能成像方式在副交感神经头颈部副神经节瘤（HNPGLs）中的临床应用价值，并与CT/MRI解剖成像以及其他功能成像方式进行比较，包括（18）F-氟代羟基苯丙氨酸（（18）F-FDOPA）PET/CT，其目前是HNPGLs功能成像的金标准。
对20例HNPGLs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-FDOPA PET/CT、（18）F-FDG PET/CT和CT/MRI检查，其中18例患者还接受了（18）F-氟多巴胺（（18）F-FDA）PET/CT检查。（18）F-FDOPA PET/CT和CT/MRI作为成像对照。
在20例患者中检测到38个病灶，（18）F-FDOPA PET/CT识别出38个病灶中的37个，CT/MRI识别出38个病灶中的23个（P < 0.01）。（68）Ga-DOTATATE PET/CT检测到了所有38个病灶以及另外7个病灶（P = 0.016）。（18）F-FDG PET/CT（24/38，P < 0.01）和（18）F-FDA PET/CT（10/34，P < 0.01）识别出的病灶明显较少。
（68）Ga-DOTATATE PET/CT识别出的病灶比其他成像方式更多。基于本研究结果，以及DOTA类似物在神经内分泌肿瘤治疗中的可用性和使用日益增加，我们预计在不久的将来，（68）Ga-DOTATATE PET/CT将成为HNPGLs首选的功能成像方式。
