AIMS AND METHODS: The aim of this prospective study was to compare the diagnostic value of [¹⁸F]FDOPA-PET and [¹¹¹In]pentetreotide-SPECT somatostatin receptor scintigraphy (SRS) in patients with nonmetastatic extra-adrenal paragangliomas (PGLs). Twenty-five consecutive unrelated patients who were known or suspected of having nonmetastatic extra-adrenal PGLs were prospectively evaluated with SRS and [¹⁸F]FDOPA-PET. ¹³¹I-MIBG and [¹⁸F]FDG-PET were added to the work-up in patients with a personal or familial history of PGL, predisposing mutations, abdominal PGLs, metanephrine hypersecretion and abdominal foci on SRS and/or [¹⁸F]FDOPA-PET. RESULTS: SRS correctly detected 23/45 lesions of which 20 were head or neck lesions (H&N) and 3 were abdominal lesions. [¹⁸F]FDOPA-PET detected significantly more lesions than SRS (39/45, P < 0·001). Both SRS and ¹⁸F-DOPA-PET detected significantly more H&N than abdominal lesions (66·7% vs 20%, P = 0·003 and 96·7% vs 67%, P = 0·012, respectively). In two patients with the succinate dehydrogenase D (SDHD) mutation, [¹⁸F]FDOPA-PET missed five abdominal PGLs which were detected by the combination of SRS, [¹³¹I]MIBG and [¹⁸F]FDG-PET. A lesion-based analysis using a forward stepwise logistic regression model demonstrates that size ≤ 10 mm (P = 0·002) and abdominal lesions (P = 0·031) were independently associated with "[¹⁸F]FDOPA-PET diagnosis only". In turn, a previous history of surgery and/or the presence of germline mutation was associated with lower lesion size (P = 0·001). CONCLUSIONS: The sensitivity of SRS for localizing parasympathetic PGLs is lower than originally reported, and [¹⁸F]FDOPA-PET is better than SRS for localizing small lesions. SRS should be replaced by [¹⁸F]FDOPA-PET as the first-line imaging procedure in H&N PGL, especially in patients at risk of multifocal disease (predisposing mutations and or previous history of surgery).
AIMS AND METHODS: The aim of this prospective study was to compare the diagnostic value of [¹⁸F]FDOPA-PET and [¹¹¹In]pentetreotide-SPECT somatostatin receptor scintigraphy (SRS) in patients with nonmetastatic extra-adrenal paragangliomas (PGLs). Twenty-five consecutive unrelated patients who were known or suspected of having nonmetastatic extra-adrenal PGLs were prospectively evaluated with SRS and [¹⁸F]FDOPA-PET. ¹³¹I-MIBG and [¹⁸F]FDG-PET were added to the work-up in patients with a personal or familial history of PGL, predisposing mutations, abdominal PGLs, metanephrine hypersecretion and abdominal foci on SRS and/or [¹⁸F]FDOPA-PET. RESULTS:SRS correctly detected 23/45 lesions of which 20 were head or neck lesions (H&N) and 3 were abdominal lesions. [¹⁸F]FDOPA-PET detected significantly more lesions than SRS (39/45, P < 0·001). Both SRS and ¹⁸F-DOPA-PET detected significantly more H&N than abdominal lesions (66·7% vs 20%, P = 0·003 and 96·7% vs 67%, P = 0·012, respectively). In two patients with the succinate dehydrogenase D (SDHD) mutation, [¹⁸F]FDOPA-PET missed five abdominal PGLs which were detected by the combination of SRS, [¹³¹I]MIBG and [¹⁸F]FDG-PET. A lesion-based analysis using a forward stepwise logistic regression model demonstrates that size ≤ 10 mm (P = 0·002) and abdominal lesions (P = 0·031) were independently associated with "[¹⁸F]FDOPA-PET diagnosis only". In turn, a previous history of surgery and/or the presence of germline mutation was associated with lower lesion size (P = 0·001). CONCLUSIONS: The sensitivity of SRS for localizing parasympathetic PGLs is lower than originally reported, and [¹⁸F]FDOPA-PET is better than SRS for localizing small lesions. SRS should be replaced by [¹⁸F]FDOPA-PET as the first-line imaging procedure in H&N PGL, especially in patients at risk of multifocal disease (predisposing mutations and or previous history of surgery).
Authors: David Taïeb; Alexandre Kaliski; Carsten C Boedeker; Victoria Martucci; Tito Fojo; John R Adler; Karel Pacak Journal: Endocr Rev Date: 2014-07-17 Impact factor: 19.871
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Authors: J B Maurice; R Troke; Z Win; R Ramachandran; A Al-Nahhas; M Naji; W Dhillo; K Meeran; A P Goldstone; N M Martin; J F Todd; F Palazzo; T Tan Journal: Eur J Nucl Med Mol Imaging Date: 2012-04-20 Impact factor: 9.236
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Authors: David Taïeb; Henri J Timmers; Elif Hindié; Benjamin A Guillet; Hartmut P Neumann; Martin K Walz; Giuseppe Opocher; Wouter W de Herder; Carsten C Boedeker; Ronald R de Krijger; Arturo Chiti; Adil Al-Nahhas; Karel Pacak; Domenico Rubello Journal: Eur J Nucl Med Mol Imaging Date: 2012-08-28 Impact factor: 9.236
Authors: Aurélien Archier; Arthur Varoquaux; Philippe Garrigue; Marion Montava; Carole Guerin; Sophie Gabriel; Eva Beschmout; Isabelle Morange; Nicolas Fakhry; Frédéric Castinetti; Frédéric Sebag; Anne Barlier; Anderson Loundou; Benjamin Guillet; Karel Pacak; David Taïeb Journal: Eur J Nucl Med Mol Imaging Date: 2015-12-05 Impact factor: 9.236