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Erschienen in:
01.05.2011 | Original Article
Functional imaging in phaeochromocytoma and neuroblastoma with 68Ga-DOTA-Tyr3-octreotide positron emission tomography and 123I-metaiodobenzylguanidine
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 5/2011
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Purpose
68Ga-DOTA-Tyr3-octreotide positron emission tomography (68Ga-DOTA-TOC PET) has proven to be superior to 111In-DTPA-D-Phe1-octreotide (111In-octreotide) planar scintigraphy and SPECT imaging in neuroendocrine tumours (NETs). Because of these promising results, we compared the accuracy of 123I-metaiodobenzylguanidine (123I-MIBG) imaging with PET in the diagnosis and staging of metastatic phaeochromocytoma and neuroblastoma, referring to radiological imaging as reference standard.
Methods
Three male and eight female patients (age range 3 to 68 years) with biochemically and histologically proven disease were included in this study. Three male and three female patients were suffering from phaeochromocytoma, and five female patients from neuroblastoma. Comparative evaluation included morphological imaging with CT or MRI, functional imaging with 68Ga-DOTA-TOC PET and 123I-MIBG imaging. Imaging results were analysed on a per-patient and on a per-lesion basis.
Results
On a per-patient basis, both 68Ga-DOTA-TOC and 123I-MIBG showed a sensitivity of 100%, when compared with anatomical imaging. In phaeochromocytoma patients, on a per-lesion basis, the sensitivity of 68Ga-DOTA-TOC was 91.7% and that of 123I-MIBG was 63.3%. In neuroblastoma patients, on a per-lesion basis, the sensitivity of 68Ga-DOTA-TOC was 97.2% and that of 123I-MIBG was 90.7%. Overall, in this patient cohort, 68Ga-DOTA-TOC PET identified 257 lesions, anatomical imaging identified 216 lesions, and 123I-MIBG identified only 184 lesions. In this patient group, the overall sensitivity of 68Ga-DOTA-TOC PET on a lesion basis was 94.4% (McNemar p<0.0001) and that of 123I-MIBG was 76.9% (McNemar p<0.0001).
Conclusion
Our analysis in this relatively small patient cohort indicates that 68Ga-DOTA-TOC PET may be superior to 123I-MIBG gamma-scintigraphy and even to the reference CT/MRI technique in providing particularly valuable information for pretherapeutic staging of phaeochromocytoma and neuroblastoma.