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

2016; Springer Science+Business Media; Volume: 43; Issue: 10 Linguagem: Inglês

10.1007/s00259-016-3357-x

1619-7089

Ingo Janssen, Clara C. Chen, Corina Millo, Alexander Ling, David Taïeb, Frank I. Lin, Karen T. Adams, Katherine I. Wolf, Peter Herscovitch, Antonio Tito Fojo, Inga Buchmann, Electron Kebebew, Karel Pacák,

Pituitary Gland Disorders and Treatments

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. 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. 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. 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.