Shahrokhi Pezhman, Emami-Ardekani Alireza, Harsini Sara, Eftekhari Mohammad, Fard-Esfahani Armaghan, Fallahi Babak, Karamzade Ziarati Najme, Akhlaghi Mehdi, Farzanefar Saeed, Hashemi Taheri Amir Pejman, Beiki Davood
Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
These authors shared first authorship.
Asia Ocean J Nucl Med Biol. 2020 Winter;8(1):8-17. doi: 10.22038/aojnmb.2019.41343.1280.
Ga-DOTATATE positron emission tomography (PET)/computed tomography (CT) has shown promising results in imaging of neural crest tumors (NCT). Herein, we compared the performance of Ga-DOTATATE PET/CT and I-MIBG single photon emission computed tomography (SPECT)/CT in the initial diagnosis, staging and follow-up of patients with NCTs.
Twenty-five patients (males:females=8:17; age range=2-71 years) with clinically proven or suspicious neuroblastoma, pheochromocytoma (PCC) or paraganglioma (PGL) were enrolled in this prospective study and underwent both Ga-DOTATATE PET/CT and I-MIBG SPECT/CT. A composite reference standard derived from histopathological information, together with anatomical and functional imaging findings, was used to validate the results. Imaging findings were assessed on a per-patient and on a per-lesion basis. Sensitivity and accuracy were assessed using McNemar's test.
Referring to radiological imaging and histopathological findings as reference standard, Ga-DOTATATE and I-MIBG scans showed a sensitivity and accuracy of (100%, 96%) and (86.7%, 88%), respectively, on a per-patient basis. In PCC/PGL patients, on a per-patient basis, the sensitivity of Ga-DOTATATE was 100% and that of I-MIBG was 77.8%. In neuroblastoma patients, on a per-patient basis, the sensitivities of both Ga-DOTATATE and I-MIBG were 100%. Overall, in this patient cohort, Ga-DOTATATE PET/CT identified 52 lesions and I-MIBG SPECT/CT identified only 30 lesions. On a per-lesion analysis, Ga-DOTATATE was found to be superior to I-MIBG in detecting lesions in all anatomical locations, particularly osseous lesions. According to the McNemar test results, differences were not statistically significant.
This relatively small patient cohort suggests Ga-DOTATATE PET/CT be superior to I-MIBG SPECT/CT in providing particularly valuable information for both primary staging and follow-up in patients with NCT.
镓- DOTATATE正电子发射断层扫描（PET）/计算机断层扫描（CT）在神经嵴肿瘤（NCT）成像方面已显示出有前景的结果。在此，我们比较了镓- DOTATATE PET/CT和碘-间位碘代苄胍（I- MIBG）单光子发射计算机断层扫描（SPECT）/CT在NCT患者初始诊断、分期及随访中的性能。
25例临床确诊或疑似神经母细胞瘤、嗜铬细胞瘤（PCC）或副神经节瘤（PGL）的患者（男∶女 = 8∶17；年龄范围2 - 71岁）纳入这项前瞻性研究，并接受了镓- DOTATATE PET/CT和I- MIBG SPECT/CT检查。采用源自组织病理学信息以及解剖和功能成像结果的综合参考标准来验证结果。对每位患者及每个病灶的成像结果进行评估。使用McNemar检验评估敏感性和准确性。
以放射学成像和组织病理学结果作为参考标准，在每位患者基础上，镓- DOTATATE和I- MIBG扫描的敏感性和准确性分别为（100%，96%）和（86.7%，88%）。在PCC/PGL患者中，在每位患者基础上，镓- DOTATATE的敏感性为100%，I- MIBG的敏感性为77.8%。在神经母细胞瘤患者中，在每位患者基础上，镓- DOTATATE和I- MIBG的敏感性均为100%。总体而言，在该患者队列中，镓- DOTATATE PET/CT识别出52个病灶，而I- MIBG SPECT/CT仅识别出30个病灶。在每个病灶分析中，发现镓- DOTATATE在检测所有解剖部位的病灶方面优于I- MIBG，尤其是骨病灶。根据McNemar检验结果，差异无统计学意义。
这个相对较小的患者队列表明，镓- DOTATATE PET/CT在为NCT患者的初始分期和随访提供特别有价值的信息方面优于I- MIBG SPECT/CT。
