Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
European Journal of Nuclear Medicine and Molecular Imaging
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging 10/2016

21.03.2016 | Original Article

PET/CT comparing 68Ga-DOTATATE and other radiopharmaceuticals and in comparison with CT/MRI for the localization of sporadic metastatic pheochromocytoma and paraganglioma

verfasst von: Ingo Janssen, Clara C. Chen, Corina M. Millo, Alexander Ling, David Taieb, Frank I. Lin, Karen T. Adams, Katherine I. Wolf, Peter Herscovitch, Antonio T. Fojo, Inga Buchmann, Electron Kebebew, Karel Pacak

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 10/2016

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Pheochromocytomas/paragangliomas (PPGLs) and their metastases are tumors that predominantly express somatostatin receptor 2 (SSR2). 68Ga-DOTA(0)-Tyr(3)-octreotate (68Ga-DOTATATE) is a PET radiopharmaceutical with both high and selective affinity for SSRs. The purpose of this study was to evaluate the utility of 68Ga-DOTATATE in comparison with other specific and nonspecific radiopharmaceuticals recommended in the current guidelines for the localization of metastatic sporadic PPGL by PET/CT.

Methods

This prospective study included 22 patients (15 men, 7 women; aged 50.0 ± 13.9 years) with confirmed metastatic PPGL, a negative family history for PPGL, and negative genetic testing, who underwent 68Ga-DOTATATE, 18F-fluoro-2-deoxy-D-glucose (18F-FDG) PET/CT, and CT/MRI. Only 12 patients underwent an additional 18F-fluorodihydroxyphenylalanine (18F-FDOPA) PET/CT scan and only 11 patients underwent an additional 18F-fluorodopamine (18F-FDA) PET/CT scan. The rates of detection of metastatic lesions were compared among all the imaging studies. A composite of all functional and anatomical imaging studies served as the imaging comparator.

Results

68Ga-DOTATATE PET/CT showed a lesion-based detection rate of 97.6 % (95 % confidence interval, CI, 95.8 – 98.7 %). 18F-FDG PET/CT, 18F-FDOPA PET/CT, 18F-FDA PET/CT, and CT/MRI showed detection rates of 49.2 % (CI 44.5 – 53.6 %; p < 0.01), 74.8 % (CI 69.0 – 79.9 %); p < 0.01), 77.7 % (CI 71.5 – 82.8 %; p < 0.01), and 81.6 % (CI 77.8 – 84.8 %; p < 0.01), respectively.

Conclusion

The results of this study demonstrate the superiority of 68Ga-DOTATATE PET/CT in the localization of sporadic metastatic PPGLs compared to all other functional and anatomical imaging modalities, and suggest modification of future guidelines towards this new imaging modality.
Literatur
1.
DeLellis RA. Pathology and genetics of tumours of endocrine organs. Lyon: IARC Press; 2004.
2.
3.
Matro J, Giubellino A, Pacak K. Current and future therapeutic approaches for metastatic pheochromocytoma and paraganglioma: focus on SDHB tumors. Horm Metab Res. 2013;45:147–53.CrossRefPubMedPubMedCentral
4.
Turkova H, Prodanov T, Maly M, Martucci V, Adams K, Widimsky Jr J, et al. Characteristics and outcomes of metastatic SDHB and sporadic pheochromocytoma/paraganglioma: a National Institutes of Health study. Endocr Pract. 2016;22:302–14.
5.
Reubi JC, Waser B, Schaer JC, Laissue JA. Somatostatin receptor sst1-sst5 expression in normal and neoplastic human tissues using receptor autoradiography with subtype-selective ligands. Eur J Nucl Med. 2001;28:836–46.CrossRefPubMed
6.
Sadowski SM, Millo C, Cottle-Delisle C, Merkel R, Yang LA, Herscovitch P, et al. Results of (68)gallium-DOTATATE PET/CT scanning in patients with multiple endocrine neoplasia type 1. J Am Coll Surg. 2015;221:509–17.CrossRefPubMedPubMedCentral
7.
Tan TH, Hussein Z, Saad FF, Shuaib IL. Diagnostic performance of (68)Ga-DOTATATE PET/CT, (18)F-FDG PET/CT and (131)I-MIBG scintigraphy in mapping metastatic pheochromocytoma and paraganglioma. Nucl Med Mol Imaging. 2015;49:143–51.CrossRefPubMedPubMedCentral
8.
Naji M, Zhao C, Welsh SJ, Meades R, Win Z, Ferrarese A, et al. 68Ga-DOTA-TATE PET vs. 123I-MIBG in identifying malignant neural crest tumours. Mol Imaging Biol. 2011;13:769–75.CrossRefPubMed
9.
Win Z, Al-Nahhas A, Towey D, Todd JF, Rubello D, Lewington V, et al. 68Ga-DOTATATE PET in neuroectodermal tumours: first experience. Nucl Med Commun. 2007;28:359–63.CrossRefPubMed
10.
Sharma P, Thakar A, Suman KC, Dhull VS, Singh H, Naswa N, et al. 68Ga-DOTANOC PET/CT for baseline evaluation of patients with head and neck paraganglioma. J Nucl Med. 2013;54:841–7.CrossRefPubMed
11.
Naswa N, Sharma P, Nazar AH, Agarwal KK, Kumar R, Ammini AC, et al. Prospective evaluation of 68Ga-DOTA-NOC PET-CT in phaeochromocytoma and paraganglioma: preliminary results from a single centre study. Eur Radiol. 2012;22:710–9.CrossRefPubMed
12.
Puranik AD, Kulkarni HR, Singh A, Baum RP. Peptide receptor radionuclide therapy with (90)Y/ (177)Lu-labelled peptides for inoperable head and neck paragangliomas (glomus tumours). Eur J Nucl Med Mol Imaging. 2015;42:1223–30.CrossRefPubMed
13.
Janssen I, Blanchet EM, Adams K, Chen CC, Millo CM, Herscovitch P, et al. Superiority of [68Ga]-DOTATATE PET/CT to other functional imaging modalities in the localization of SDHB-associated metastatic pheochromocytoma and paraganglioma. Clin Cancer Res. 2015;21:3888–95.CrossRefPubMed
14.
Taieb D, Neumann H, Rubello D, Al-Nahhas A, Guillet B, Hindie E. Modern nuclear imaging for paragangliomas: beyond SPECT. J Nucl Med. 2012;53:264–74.CrossRefPubMed
15.
Timmers HJ, Kozupa A, Chen CC, Carrasquillo JA, Ling A, Eisenhofer G, et al. Superiority of fluorodeoxyglucose positron emission tomography to other functional imaging techniques in the evaluation of metastatic SDHB-associated pheochromocytoma and paraganglioma. J Clin Oncol. 2007;25:2262–9.CrossRefPubMed
16.
Elston MS, Meyer-Rochow GY, Conaglen HM, Clarkson A, Clifton-Bligh RJ, Conaglen JV, et al. Increased SSTR2A and SSTR3 expression in succinate dehydrogenase-deficient pheochromocytomas and paragangliomas. Hum Pathol. 2015;46:390–6.CrossRefPubMed
17.
Timmers HJ, Chen CC, Carrasquillo JA, Whatley M, Ling A, Havekes B, et al. Comparison of 18F-fluoro-L-DOPA, 18F-fluoro-deoxyglucose, and 18F-fluorodopamine PET and 123I-MIBG scintigraphy in the localization of pheochromocytoma and paraganglioma. J Clin Endocrinol Metab. 2009;94:4757–67.CrossRefPubMedPubMedCentral
18.
Fonte JS, Robles JF, Chen CC, Reynolds J, Whatley M, Ling A, et al. False-negative 123I-MIBG SPECT is most commonly found in SDHB-related pheochromocytoma or paraganglioma with high frequency to develop metastatic disease. Endocr Relat Cancer. 2012;19:83–93.CrossRefPubMedPubMedCentral
19.
Loh KC, Fitzgerald PA, Matthay KK, Yeo PP, Price DC. The treatment of malignant pheochromocytoma with iodine-131 metaiodobenzylguanidine (131I-MIBG): a comprehensive review of 116 reported patients. J Endocrinol Invest. 1997;20:648–58.CrossRefPubMed
20.
Niemeijer ND, Alblas G, van Hulsteijn LT, Dekkers OM, Corssmit EP. Chemotherapy with cyclophosphamide, vincristine and dacarbazine for malignant paraganglioma and pheochromocytoma: systematic review and meta-analysis. Clin Endocrinol (Oxf). 2014;81:642–51.CrossRef
21.
Lenders JW, Duh QY, Eisenhofer G, Gimenez-Roqueplo AP, Grebe SK, Murad MH, et al. Pheochromocytoma and paraganglioma: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2014;99:1915–42.CrossRefPubMed
22.
Hofman MS, Hicks RJ. Moving beyond “lumpology”: PET/CT imaging of pheochromocytoma and paraganglioma. Clin Cancer Res. 2015;21:3815–7.CrossRefPubMed
23.
Timmers HJ, Hadi M, Carrasquillo JA, Chen CC, Martiniova L, Whatley M, et al. The effects of carbidopa on uptake of 6-18F-fluoro-L-DOPA in PET of pheochromocytoma and extraadrenal abdominal paraganglioma. J Nucl Med. 2007;48:1599–606.CrossRefPubMed
24.
Taieb D, Timmers HJ, Hindie E, Guillet BA, Neumann HP, Walz MK, et al. EANM 2012 guidelines for radionuclide imaging of phaeochromocytoma and paraganglioma. Eur J Nucl Med Mol Imaging. 2012;39:1977–95.CrossRefPubMedPubMedCentral
25.
Belhocine T, Spaepen K, Dusart M, Castaigne C, Muylle K, Bourgeois P, et al. 18FDG PET in oncology: the best and the worst. Int J Oncol. 2006;28:1249–61.PubMed
26.
27.
Jochmanova I, Yang C, Zhuang Z, Pacak K. Hypoxia-inducible factor signaling in pheochromocytoma: turning the rudder in the right direction. J Natl Cancer Inst. 2013;105:1270–83.CrossRefPubMedPubMedCentral
28.
Timmers HJ, Chen CC, Carrasquillo JA, Whatley M, Ling A, Eisenhofer G, et al. Staging and functional characterization of pheochromocytoma and paraganglioma by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography. J Natl Cancer Inst. 2012;104:700–8.CrossRefPubMedPubMedCentral
29.
Havekes B, King K, Lai EW, Romijn JA, Corssmit EP, Pacak K. New imaging approaches to phaeochromocytomas and paragangliomas. Clin Endocrinol (Oxf). 2010;72:137–45.CrossRef
30.
Timmers HJ, Eisenhofer G, Carrasquillo JA, Chen CC, Whatley M, Ling A, et al. Use of 6-[18F]-fluorodopamine positron emission tomography (PET) as first-line investigation for the diagnosis and localization of non-metastatic and metastatic phaeochromocytoma (PHEO). Clin Endocrinol (Oxf). 2009;71:11–7.CrossRef
31.
Sounness BD, Schembri GP. 68Ga-Dotatate avid medullary thyroid cancer with occult liver metastases. Clin Nucl Med. 2014;39:87–90.CrossRefPubMed
32.
Kroiss A, Putzer D, Decristoforo C, Uprimny C, Warwitz B, Nilica B, et al. 68Ga-DOTA-TOC uptake in neuroendocrine tumour and healthy tissue: differentiation of physiological uptake and pathological processes in PET/CT. Eur J Nucl Med Mol Imaging. 2013;40:514–23.CrossRefPubMed
33.
van Hulsteijn LT, van Duinen N, Verbist BM, Jansen JC, van der Klaauw AA, Smit JW, et al. Effects of octreotide therapy in progressive head and neck paragangliomas: case series. Head Neck. 2013;35:E391–6.CrossRefPubMed
34.
Lecouvet FE, Talbot JN, Messiou C, Bourguet P, Liu Y, de Souza NM. Monitoring the response of bone metastases to treatment with magnetic resonance imaging and nuclear medicine techniques: a review and position statement by the European Organisation for Research and Treatment of Cancer Imaging Group. Eur J Cancer. 2014;50:2519–31.CrossRefPubMed
35.
Hofman MS, Kong G, Neels OC, Eu P, Hong E, Hicks RJ. High management impact of Ga-68 DOTATATE (GaTate) PET/CT for imaging neuroendocrine and other somatostatin expressing tumours. J Med Imaging Radiat Oncol. 2012;56:40–7.CrossRefPubMed
36.
Maurice JB, Troke R, Win Z, Ramachandran R, Al-Nahhas A, Naji M, et al. A comparison of the performance of 68Ga-DOTATATE PET/CT and 123I-MIBG SPECT in the diagnosis and follow-up of phaeochromocytoma and paraganglioma. Eur J Nucl Med Mol Imaging. 2012;39:1266–70.CrossRefPubMed
37.
Yang J, Kan Y, Ge BH, Yuan L, Li C, Zhao W. Diagnostic role of gallium-68 DOTATOC and gallium-68 DOTATATE PET in patients with neuroendocrine tumors: a meta-analysis. Acta Radiol. 2014;55:389–98.CrossRefPubMed
Metadaten
Titel
PET/CT comparing 68Ga-DOTATATE and other radiopharmaceuticals and in comparison with CT/MRI for the localization of sporadic metastatic pheochromocytoma and paraganglioma
verfasst von
Ingo Janssen
Clara C. Chen
Corina M. Millo
Alexander Ling
David Taieb
Frank I. Lin
Karen T. Adams
Katherine I. Wolf
Peter Herscovitch
Antonio T. Fojo
Inga Buchmann
Electron Kebebew
Karel Pacak
Publikationsdatum
21.03.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 10/2016
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-016-3357-x

Weitere Artikel der Ausgabe 10/2016

European Journal of Nuclear Medicine and Molecular Imaging 10/2016 Zur Ausgabe

Image of the Month

18F-FDG hepatic superscan caused by a non-germinal center subtype of diffuse large B-cell lymphoma

Editorial

PET/CT is a cost-effective tool against cancer: synergy supersedes singularity

Original Article

Monitoring metabolic response using FDG PET-CT during targeted therapy for metastatic colorectal cancer

Review Article

Contribution of 18F-FDG PET in the diagnostic assessment of fever of unknown origin (FUO): a stratification-based meta-analysis

Review Article

Radium-223 dichloride in clinical practice: a review

Erratum

Erratum to: Development of a nomogram combining clinical staging with 18F-FDG PET/CT image features in non-small-cell lung cancer stage I–III