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European Journal of Nuclear Medicine and Molecular Imaging

Erschienen in:

01.12.2013 | Original Article

A retrospective comparison between ⁶⁸Ga-DOTA-TOC PET/CT and ¹⁸F-DOPA PET/CT in patients with extra-adrenal paraganglioma

verfasst von: Alexander Kroiss, Daniel Putzer, Andreas Frech, Clemens Decristoforo, Christian Uprimny, Rudolf Wolfgang Gasser, Barry Lynn Shulkin, Christoph Url, Gerlig Widmann, Rupert Prommegger, Georg Mathias Sprinzl, Gustav Fraedrich, Irene Johanna Virgolini

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 12/2013

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Abstract

Purpose

¹⁸F-Fluoro-l-dihydroxyphenylalanine (¹⁸F-DOPA) PET offers high sensitivity and specificity in the imaging of nonmetastatic extra-adrenal paragangliomas (PGL) but lower sensitivity in metastatic or multifocal disease. These tumours are of neuroendocrine origin and can be detected by ⁶⁸Ga-DOTA-Tyr³-octreotide (⁶⁸Ga-DOTA-TOC) PET. Therefore, we compared ⁶⁸Ga-DOTA-TOC and ¹⁸F-DOPA as radiolabels for PET/CT imaging for the diagnosis and staging of extra-adrenal PGL. Combined cross-sectional imaging was the reference standard.

Methods

A total of 5 men and 15 women (age range 22 to 73 years) with anatomical and/or histologically proven extra-adrenal PGL were included in this study. Of these patients, 5 had metastatic or multifocal lesions and 15 had single sites of disease. Comparative evaluation included morphological imaging with CT and functional imaging with ⁶⁸Ga-DOTA-TOC PET and ¹⁸F-DOPA PET. The imaging results were analysed on a per-patient and a per-lesion basis. The maximum standardized uptake value (SUV_max) of each functional imaging modality in concordant tumour lesions was measured.

Results

Compared with anatomical imaging, ⁶⁸Ga-DOTA-TOC PET and ¹⁸F-DOPA PET each had a per-patient and per-lesion detection rate of 100 % in nonmetastatic extra-adrenal PGL. However, in metastatic or multifocal disease, the per-lesion detection rate of ⁶⁸Ga-DOTA-TOC was 100 % and that of ¹⁸F-DOPA PET was 56.0 %. Overall, ⁶⁸Ga-DOTA-TOC PET identified 45 lesions; anatomical imaging identified 43 lesions, and ¹⁸F-DOPA PET identified 32 lesions. The overall per-lesion detection rate of ⁶⁸Ga-DOTA-TOC PET was 100 % (McNemar, P < 0.5), and that of ¹⁸F-DOPA PET was 71.1 % (McNemar, P < 0.001). The SUV_max (mean ± SD) of all 32 concordant lesions was 67.9 ± 61.5 for ⁶⁸Ga-DOTA-TOC PET and 11.8 ± 7.9 for ¹⁸F-DOPA PET (Mann-Whitney U test, P < 0.0001).

Conclusion

⁶⁸Ga-DOTA-TOC PET may be superior to ¹⁸F-DOPA PET and diagnostic CT in providing valuable information for pretherapeutic staging of extra-adrenal PGL, particularly in surgically inoperable tumours and metastatic or multifocal disease.

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Titel: A retrospective comparison between 68Ga-DOTA-TOC PET/CT and 18F-DOPA PET/CT in patients with extra-adrenal paraganglioma
verfasst von: Alexander Kroiss
Daniel Putzer
Andreas Frech
Clemens Decristoforo
Christian Uprimny
Rudolf Wolfgang Gasser
Barry Lynn Shulkin
Christoph Url
Gerlig Widmann
Rupert Prommegger
Georg Mathias Sprinzl
Gustav Fraedrich
Irene Johanna Virgolini
Publikationsdatum: 01.12.2013
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 12/2013
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-013-2548-y

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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