Dodamani Manjunath Havalappa, Jaiswal Sanjeet Kumar, Sarathi Vijaya, Marfatia Hetal, D'Cruz Anil, Malhotra Gaurav, Hira Priya, Patil Virendra A, Lila Anurag R, Shah Nalini S, Bandgar Tushar R
Department of Endocrinology, Seth G.S. Medical College & KEM Hospital, Mumbai, Maharashtra, India.
Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India.
World J Nucl Med. 2022 Aug 16;21(3):184-191. doi: 10.1055/s-0042-1751030. eCollection 2022 Sep.
This study aimed to compare the sensitivity of Ga-DOTATATE positron emission tomography/computed tomography (PET/CT) with other imaging modalities in the detection of head and neck paraganglioma (HNPGL). The data of consecutive HNPGL patients ( = 34) who had undergone at least Ga-DOTATATE PET/CT and anatomical imaging (contrast-enhanced computed tomography/magnetic resonance imaging [CECT/MRI]) were retrospectively reviewed. The diagnosis of HNPGL (the primary tumor) was confirmed either by histopathology ( = 10) or was based on clinical follow-up and correlation of anatomical with functional imaging in whom histopathology was not available ( = 24). The sensitivities of Ga DOTATATE PET/CT, 18F-fluorodeoxyglucose positron emission tomography/computed tomography ( F-FDG-PET/CT), I-metaiodobenzylguanidine ( I-MIBG) scintigraphy, and CECT/MRI for primary HNPGL, associated primary pheochromocytoma + sympathetic paraganglioma (PCC + sPGL), and metastatic lesions were analyzed. Thirty-four patients (males: 15) [isolated HNPGL: 26, HNPGL + PCC: 04, HNPGL+ sPGL: 03, HNPGL + PCC + sPGL: 01] harboring 50 primary lesions were included. For total lesions, Ga-DOTATATE PET/CT (99.3%) had significantly higher lesion-wise sensitivity than F-FDG PET/CT (81.6%, = 0.0164), I-MIBG (15.2%, ≤0.0001), CECT (46.3%, ≤ 0.0001) but similar sensitivity as MRI neck (97%, = 0.79). On head-to-head comparison (21 primary HNPGL and 39 metastatic lesions), Ga DOTATATE PET/CT had significantly higher lesion-wise sensitivities for the detection of metastatic (100 vs. 71.9%, = 0.04) and total lesions (100 vs. 77.2%, ≤ 0.0001). Ga-DOTATATE PET/CT was the most sensitive imaging modality for the detection of HNPGL and related lesions with significantly higher lesion-wise sensitivities than those of F-FDG PET/CT, I-MIBG, and CECT.
本研究旨在比较镓[⁶⁸Ga] DOTATATE正电子发射断层扫描/计算机断层扫描（PET/CT）与其他成像方式在检测头颈部副神经节瘤（HNPGL）方面的敏感性。 对连续34例接受过至少一次镓[⁶⁸Ga] DOTATATE PET/CT和解剖成像（增强计算机断层扫描/磁共振成像[CECT/MRI]）的HNPGL患者的数据进行了回顾性分析。HNPGL（原发性肿瘤）的诊断通过组织病理学确诊（n = 10），或基于临床随访以及在无法获得组织病理学的患者中解剖学与功能成像的相关性（n = 24）。分析了镓[⁶⁸Ga] DOTATATE PET/CT、¹⁸F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（¹⁸F-FDG-PET/CT）、¹²³I-间碘苄胍（¹²³I-MIBG）闪烁显像以及CECT/MRI对原发性HNPGL、相关原发性嗜铬细胞瘤+交感神经副神经节瘤（PCC + sPGL）和转移灶的敏感性。 纳入了34例患者（男性15例）[孤立性HNPGL：26例，HNPGL + PCC：4例，HNPGL + sPGL：3例，HNPGL + PCC + sPGL：1例]，共50个原发性病灶。对于所有病灶，镓[⁶⁸Ga] DOTATATE PET/CT（99.3%）的病灶敏感性显著高于¹⁸F-FDG PET/CT（81.6%，P = 0.0164）、¹²³I-MIBG（15.2%，P≤0.0001）、CECT（46.3%，P≤0.0001），但与颈部MRI的敏感性相似（97%，P = 0.79）。在直接比较中（21个原发性HNPGL和39个转移灶），镓[⁶⁸Ga] DOTATATE PET/CT在检测转移灶（100%对71.9%，P = 0.04）和所有病灶（100%对77.2%，P≤0.0001）方面的病灶敏感性显著更高。 镓[⁶⁸Ga] DOTATATE PET/CT是检测HNPGL及相关病灶最敏感的成像方式，其病灶敏感性显著高于¹⁸F-FDG PET/CT、¹²³I-MIBG和CECT。
