Department of Otorhinolaryngology and Head and Neck Surgery.
Department of Nuclear Medicine.
Nucl Med Commun. 2021 May 1;42(5):517-522. doi: 10.1097/MNM.0000000000001362.
Juvenile nasopharyngeal angiofibroma (JNA) expresses different somatostatin cell surface receptors and Ga68 [DOTA, 1-Nal3]-octreotide (DOTANOC)-PET/computed tomography (CT) scan may be used for its imaging. Also, functional imaging with DOTANOC-PET/CT may promise of greater accuracy in the detection or exclusion of recurrent/residual JNA.
In this prospective study, five JNA patients who underwent a DOTANOC-PET-CT scan both preoperatively and postoperatively during June 2018-March 2020 were included. Postcontrast enhancement of a definite lesion was considered residual/recurrent tumor in contrast-enhanced MRI (CEMRI). In DOTANOC-PET/CT, any abnormal uptake apart from physiological sites was considered as residual lesions. Radiological results were categorized as negative, suspicious or definite residual/recurrent tumors. Any discrepancy was resolved by endoscopic biopsies.
Preoperatively all five cases of JNA showed avid DOTANOC expression in the tumor. The mean (SD) value of DOTANOC standardised uptake value in the tumor was 4.3 (1.4) (range = 2.1-6.2). In postoperative CEMRI evaluation, three of five patients had residual tumors and two had normal scans. On DOTANOC-PET/CT, two of five patients had residual tumors and three had normal scans. In one patient with residual tumor, the discrepancy with regard to tumor extent was noted in two scans, and further biopsy confirmed the findings of DOTANOC-PET/CT as accurate.
68Ga-DOTANOC-PET/CT uptake is universal in JNA and appears to be more specific in the identification of residual/recurrent JNA. In residual tumors, DOTANOC-PET/CT may have an advantage over CEMRI in the diagnosis, decision making and planning stereotactic radiation. However, these findings are to be validated in studies with larger patients.
青少年鼻咽血管纤维瘤（JNA）表达不同的生长抑素细胞表面受体，Ga68 [DOTA，1-Nal3]-奥曲肽（DOTANOC）-正电子发射断层扫描/计算机断层扫描（PET/CT）可用于其成像。此外，DOTANOC-PET/CT 的功能成像可能有望提高检测或排除复发性/残留 JNA 的准确性。
在这项前瞻性研究中，纳入了 2018 年 6 月至 2020 年 3 月期间接受 DOTANOC-PET-CT 扫描的 5 例 JNA 患者，手术前和手术后各进行一次。对比增强磁共振成像（CEMRI）中确定病变的增强被认为是残留/复发性肿瘤。在 DOTANOC-PET/CT 中，除生理性部位外的任何异常摄取均被认为是残留病变。影像学结果分为阴性、可疑或明确的残留/复发性肿瘤。任何差异均通过内镜活检解决。
术前，所有 5 例 JNA 患者的肿瘤均表现出对 DOTANOC 的强烈摄取。肿瘤的 DOTANOC 标准化摄取值平均值（标准差）为 4.3（1.4）（范围 2.1-6.2）。在术后 CEMRI 评估中，5 例患者中有 3 例有残留肿瘤，2 例有正常扫描。在 DOTANOC-PET/CT 中，5 例患者中有 2 例有残留肿瘤，3 例有正常扫描。在一名有残留肿瘤的患者中，两种扫描均发现肿瘤范围存在差异，进一步的活检证实了 DOTANOC-PET/CT 的准确结果。
68Ga-DOTANOC-PET/CT 摄取在 JNA 中是普遍的，在识别残留/复发性 JNA 方面似乎更具特异性。在残留肿瘤中，与 CEMRI 相比，DOTANOC-PET/CT 可能在诊断、决策和计划立体定向放疗方面具有优势。然而，这些发现需要在更大患者群体的研究中进行验证。
