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Nuclear Medicine and Molecular Imaging
Published in: Nuclear Medicine and Molecular Imaging 2/2015

01-06-2015 | Original Article

Diagnostic Performance of 68Ga-DOTATATE PET/CT, 18F-FDG PET/CT and 131I-MIBG Scintigraphy in Mapping Metastatic Pheochromocytoma and Paraganglioma

Authors: Teik Hin Tan, Zanariah Hussein, Fathinul Fikri Ahmad Saad, Ibrahim Lutfi Shuaib

Published in: Nuclear Medicine and Molecular Imaging | Issue 2/2015

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Abstract

Purpose

To evaluate the diagnostic performance of 68Ga-DOTATATE 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT), 18F-FDG PET/CT and 131I-MIBG scintigraphy in the mapping of metastatic pheochromocytoma and paraganglioma.

Materials and Methods

Seventeen patients (male = 8, female = 9; age range, 13–68 years) with clinically proven or suspicious metastatic pheochromocytoma or paraganglioma were included in this prospective study. Twelve patients underwent all three modalities, whereas five patients underwent 68Ga-DOTATATE and 131I-MIBG without 18F-FDG. A composite reference standard derived from anatomical and functional imaging findings, along with histopathological information, was used to validate the findings. Results were analysed on a per-patient and on per-lesion basis. Sensitivity and accuracy were assessed using McNemar’s test.

Results

On a per-patient basis, 14/17 patients were detected in 68Ga-DOTATATE, 7/17 patients in 131I-MIBG, and 10/12 patients in 18F-FDG. The sensitivity and accuracy of 68Ga-DOTATATE, 131I-MIBG and 18F-FDG were (93.3 %, 94.1 %), (46.7 %, 52.9 %) and (90.9 %, 91.7 %) respectively. On a per-lesion basis, an overall of 472 positive lesions were detected; of which 432/472 were identified by 68Ga-DOTATATE, 74/472 by 131I-MIBG, and 154/300 (patient, n = 12) by 18F-FDG. The sensitivity and accuracy of 68Ga-DOTATATE, 131I-MIBG and 18F-FDG were (91.5 %, 92.6 % p < 0.0001), (15.7 %, 26.0 % p < 0.0001) and (51.3 %, 57.8 % p < 0.0001) respectively. Discordant lesions were demonstrated on 68Ga-DOTATATE, 131I-MIBG and 18F-FDG.

Conclusions

Ga-DOTATATE PET/CT shows high diagnostic accuracy than 131I-MIBG scintigraphy and 18F-FDG PET/ CT in mapping metastatic pheochromocytoma and paraganglioma.
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Metadata
Title
Diagnostic Performance of 68Ga-DOTATATE PET/CT, 18F-FDG PET/CT and 131I-MIBG Scintigraphy in Mapping Metastatic Pheochromocytoma and Paraganglioma
Authors
Teik Hin Tan
Zanariah Hussein
Fathinul Fikri Ahmad Saad
Ibrahim Lutfi Shuaib
Publication date
01-06-2015
Publisher
Springer Berlin Heidelberg
Published in
Nuclear Medicine and Molecular Imaging / Issue 2/2015
Print ISSN: 1869-3474
Electronic ISSN: 1869-3482
DOI
https://doi.org/10.1007/s13139-015-0331-7

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