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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 10/2016

01-09-2016 | 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

Authors: 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

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 10/2016

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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.
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Metadata
Title
PET/CT comparing 68Ga-DOTATATE and other radiopharmaceuticals and in comparison with CT/MRI for the localization of sporadic metastatic pheochromocytoma and paraganglioma
Authors
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
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 10/2016
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-016-3357-x

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