From the *Department of Nuclear Medicine, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Science & PUMC, Beijing; †Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing; and ‡Department of Endocrinology, PUMC Hospital, Chinese Academy of Medical Science & PUMC, Beijing, China.
Clin Nucl Med. 2017 Jul;42(7):525-529. doi: 10.1097/RLU.0000000000001674.
Anatomical imaging modalities including CT and MRI are the mainstay of evaluation of primary pheochromocytoma or paraganglioma. However, nuclear medicine imaging is frequently necessary to determine the nature of the lesions. The purpose of this investigation is to assess which commonly used nuclear medicine modality might have a better diagnostic value in this clinical setting.
Eight patients who had been suspected of having either primary pheochromocytoma or primary paraganglioma and 1 patient with known pheochromocytoma were included in the analysis. Among the 8 patients without known diagnosis, 7 had been suggested by anatomical imaging modalities, whereas one of them presented with initial negative anatomical imaging interpretation. All of 9 patients underwent Ga-DOTATATA PET/CT, FDG PET/CT, and MIBG SPECT/CT for further evaluation. The imaging findings were compared with postsurgical pathology and follow-up.
Both Ga-DOTATATA PET/CT and MIBG SPECT/CT accurately identified 9 primary tumors, whereas FDG PET/CT showed increased activity in 8 of 9 primary tumors. Both Ga-DOTATATA and FDG PET/CT are able to detect associated extra-adrenal lesions not shown on MIBG study in patients with multiple endocrine neoplasia syndrome.
Ga-DOTATATA PET/CT could be the nuclear medicine imaging choice to evaluate suspected primary pheochromocytoma or paraganglioma, especially in the situation of multiple endocrine neoplasia syndrome.
包括 CT 和 MRI 在内的解剖成像方式是评估原发性嗜铬细胞瘤或副神经节瘤的主要方法。然而，核医学成像常常是确定病变性质所必需的。本研究的目的是评估哪种常用的核医学方式在这种临床情况下可能具有更好的诊断价值。
分析了 8 例疑似原发性嗜铬细胞瘤或原发性副神经节瘤的患者和 1 例已知嗜铬细胞瘤的患者。在 8 例无已知诊断的患者中，7 例经解剖成像方式提示，而其中 1 例解剖成像结果呈初始阴性。所有 9 例患者均进行了 Ga-DOTATATA PET/CT、FDG PET/CT 和 MIBG SPECT/CT 进一步评估。将影像学发现与术后病理和随访结果进行比较。
Ga-DOTATATA PET/CT 和 MIBG SPECT/CT 均准确识别了 9 个原发性肿瘤，而 FDG PET/CT 显示 9 个原发性肿瘤中有 8 个活性增加。Ga-DOTATATA 和 FDG PET/CT 均能够检测出多发性内分泌肿瘤综合征患者 MIBG 研究未显示的肾上腺外相关病变。
Ga-DOTATATA PET/CT 可能是评估疑似原发性嗜铬细胞瘤或副神经节瘤的核医学成像选择，尤其是在多发性内分泌肿瘤综合征的情况下。
