Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Med Imaging Radiat Oncol. 2024 Apr;68(3):250-256. doi: 10.1111/1754-9485.13641. Epub 2024 Apr 2.
The purpose of the study was to determine the usefulness of Ga-68 DOTATATE PET/MR in the identification of tumours in individuals with multiple endocrine neoplasia type 1 (MEN1).
In this retrospective investigation, five individuals who had tested positive for a hereditary MEN1 variant underwent Ga-68 DOTATATE PET/MR between May 2020 and January 2023. Several types of tumours associated with MEN1 were studied. MEN1-related tumours included pituitary, parathyroid, gastroenteropancreatic, and adrenal. The rates of lesion identification between MRI, Ga-68 DOTATATE PET, and Ga-68 DOTATATE PET/MRI were examined. The maximum and mean standard uptake values (SUVmax and SUVmean) were evaluated in carefully delineated volumes of interest (VOI) for the relevant tumours.
Of the 24 primary lesions, 14 were identified by Ga-68 DOTATATE PET, 18 by MRI, and 20 by Ga-68 DOTATATE PET/MRI. Two pituitary tumours were detected by all three techniques. All parathyroid tumours that were not detected by Ga-68 DOTATATE PET and MRI were found by Tc-99m MIBI SPECT/CT or/and EUS. Ga-68 DOTATATE PET/MR detected more gastroenteropancreatic lesions. All adrenal tumours not identified by Ga-68 DOTATATE PET were found by MRI or CT. The median SUVmax for lesions identified on Ga-68 DOTATATE PET/MRI was 18.4 (range, 3.8-85.2), and the median SUVmean was 12.0 (range, 2.3-49.8).
The combination of Ga-68 DOTATATE PET and MRI demonstrated a higher detection rate and may be more useful in the work-up of MEN1 providing a panoramic view of MEN1-related lesions. To increase the identification of MEN1-associated neuroendocrine lesions in the parathyroid gland, approaches other than Ga-68 DOTATATE PET/MRI should be used.
本研究的目的是确定 Ga-68 DOTATATE PET/MR 在多发性内分泌肿瘤 1 型（MEN1）个体中肿瘤识别的有用性。
在这项回顾性研究中，五名遗传性 MEN1 变异体检测呈阳性的个体于 2020 年 5 月至 2023 年 1 月期间接受了 Ga-68 DOTATATE PET/MR 检查。研究了几种与 MEN1 相关的肿瘤。MEN1 相关的肿瘤包括垂体、甲状旁腺、胃肠胰腺和肾上腺。检查了 MRI、Ga-68 DOTATATE PET 和 Ga-68 DOTATATE PET/MRI 之间的病变识别率。在相关肿瘤的仔细勾画的兴趣区（VOI）中评估了最大和平均标准摄取值（SUVmax 和 SUVmean）。
在 24 个原发性病变中，14 个通过 Ga-68 DOTATATE PET 检出，18 个通过 MRI 检出，20 个通过 Ga-68 DOTATATE PET/MRI 检出。所有三种技术均检测到两个垂体肿瘤。所有未通过 Ga-68 DOTATATE PET 和 MRI 检测到的甲状旁腺肿瘤均通过 Tc-99m MIBI SPECT/CT 或/和 EUS 发现。Ga-68 DOTATATE PET/MR 检测到更多的胃肠胰腺病变。所有未通过 Ga-68 DOTATATE PET 检测到的肾上腺肿瘤均通过 MRI 或 CT 发现。在 Ga-68 DOTATATE PET/MRI 上检测到的病变的中位数 SUVmax 为 18.4（范围，3.8-85.2），中位数 SUVmean 为 12.0（范围，2.3-49.8）。
Ga-68 DOTATATE PET 和 MRI 的组合显示出更高的检测率，并且在 MEN1 的检查中可能更有用，提供 MEN1 相关病变的全景图。为了增加对甲状旁腺中 MEN1 相关神经内分泌病变的识别，应使用 Ga-68 DOTATATE PET/MRI 以外的方法。
