Else Tobias, Wong Ka Kit, Frey Kirk A, Brooks Allen F, Viglianti Benjamin L, Raffel David M
Endocrinology, Metabolism, and Diabetes, University of Michigan, Ann Arbor, MI 48109-5674, USA.
Nuclear Medicine/Radiology, University of Michigan, Ann Arbor, MI 48109-0028, USA.
J Endocr Soc. 2024 Apr 12;8(6):bvae049. doi: 10.1210/jendso/bvae049. eCollection 2024 Apr 6.
Functional positron emission tomography (PET) imaging for the characterization of pheochromocytoma and paraganglioma (PCC/PGL) and for detection of metastases in malignant disease, offers valuable clinical insights that can significantly guide patient treatment.
This work aimed to evaluate a novel PET radiotracer, 3-[F]fluoro--hydroxyphenethylguanidine (3-[F]pHPG), a norepinephrine analogue, for its ability to localize PCC/PGL.
3-[F]pHPG PET/CT whole-body scans were performed on 16 patients (8 male:8 female; mean age 47.6 ± 17.6 years; range, 19-74 years) with pathologically confirmed or clinically diagnosed PCC/PGL. After intravenous administration of 304 to 475 MBq (8.2-12.8 mCi) of 3-[F]pHPG, whole-body PET scans were performed at 90 minutes in all patients. 3-[F]pHPG PET was interpreted for abnormal findings consistent with primary tumor or metastasis, and biodistribution in normal organs recorded. Standardized uptake value (SUV) measurements were obtained for target lesions and physiological organ distributions.
3-[F]pHPG PET showed high radiotracer uptake and trapping in primary tumors, and metastatic tumor lesions that included bone, lymph nodes, and other solid organ sites. Physiological biodistribution was universally present in salivary glands (parotid, submandibular, sublingual), thyroid, heart, liver, adrenals, kidneys, and bladder. Comparison [Ga]DOTATATE PET/CT was available in 10 patients and in all cases showed concordant distribution. Comparison [I]iodobenzylguanidine [I]mIBG planar scintigraphy and SPECT/CT scans were available for 4 patients, with 3-[F]pHPG showing a greater number of metastatic lesions.
We found the kinetic profile of 3-[F]pHPG PET affords high activity retention within benign and metastatic PCC/PGL. Therefore, 3-[F]pHPG PET imaging provides a novel modality for functional imaging and staging of malignant paraganglioma with advantages of high lesion affinity, whole-body coregistered computed tomography, and rapid same-day imaging.
功能正电子发射断层扫描（PET）成像用于嗜铬细胞瘤和副神经节瘤（PCC/PGL）的特征描述以及恶性疾病转移灶的检测，可提供有价值的临床见解，能显著指导患者治疗。
本研究旨在评估一种新型PET放射性示踪剂3-[F]氟-羟苯乙胍（3-[F]pHPG），一种去甲肾上腺素类似物，定位PCC/PGL的能力。
对16例经病理证实或临床诊断为PCC/PGL的患者（8例男性，8例女性；平均年龄47.6±17.6岁；范围19 - 74岁）进行3-[F]pHPG PET/CT全身扫描。静脉注射304至475 MBq（8.2 - 12.8 mCi）的3-[F]pHPG后，所有患者在90分钟时进行全身PET扫描。对3-[F]pHPG PET进行解读，以发现与原发性肿瘤或转移灶一致的异常表现，并记录正常器官的生物分布情况。获取靶病变和生理器官分布的标准化摄取值（SUV）测量结果。
3-[F]pHPG PET显示在原发性肿瘤以及包括骨、淋巴结和其他实体器官部位的转移瘤病灶中有高放射性示踪剂摄取和滞留。生理生物分布普遍存在于唾液腺（腮腺、颌下腺、舌下腺）、甲状腺、心脏、肝脏、肾上腺、肾脏和膀胱。10例患者可进行[Ga]DOTATATE PET/CT对比，所有病例均显示分布一致。4例患者可进行[I]碘苄胍[I]mIBG平面闪烁显像和SPECT/CT扫描，3-[F]pHPG显示出更多的转移灶。
我们发现3-[F]pHPG PET的动力学特征在良性和转移性PCC/PGL中具有高活性滞留。因此，3-[F]pHPG PET成像为恶性副神经节瘤的功能成像和分期提供了一种新的模式，具有高病变亲和力、全身配准计算机断层扫描和同日快速成像的优势。
