Sangwon Han1, Chong Hyun Suh2, Sungmin Woo3, Yeon Joo Kim4, Jong Jin Lee5. 1. Department of Nuclear Medicine, The Armed Forces Daejeon Hospital, Daejeon, Korea. 2. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 3. Department of Radiology, Seoul National University College of Medicine, Seoul, Korea; and. 4. Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 5. Department of Nuclear Medicine, The Armed Forces Daejeon Hospital, Daejeon, Korea jongjin@gmail.com.
Abstract
We performed a systematic review and metaanalysis of the performance of 68Ga-DOTA-conjugated somatostatin receptor-targeting peptide (68Ga-DOTA-SST) PET in the detection of pheochromocytomas and paragangliomas (PPGLs). Methods: PubMed and Embase were searched until May 8, 2018. We included studies that reported the detection rate of 68Ga-DOTA-SST PET in patients with PPGLs. Detection rates were pooled using a random-effects model. Subgroup analyses and metaregression were performed to explore the cause of heterogeneity. Results: Thirteen studies were included for qualitative synthesis. Per-lesion detection rates of 68Ga-DOTA-SST PET were consistently higher (ranging from 92% to 100%) than other imaging modalities, including 18F-fluorohydroxyphenylalanine (18F-FDOPA) PET, 18F-FDG PET, and 123/131I-metaiodobenzylguanidine (123/131I-MIBG) scintigraphy. However, in patients with polycythemia/paraganglioma syndrome, the detection rate of 68Ga-DOTA-DOTATATE PET was 35%. Nine studies (215 patients) with no specific inclusion criteria for subtype were quantitatively synthesized. The pooled detection rate was 93% (95% confidence interval [CI], 91%-95%), which was significantly higher than that of 18F-FDOPA PET (80% [95% CI, 69%-88%]), 18F-FDG PET (74% [95% CI, 46%-91%]), and 123/131I-MIBG scan (38% [95% CI, 20%-59%], P < 0.001 for all). A greater prevalence of head and neck paragangliomas was associated with higher detection rates of 68Ga-DOTA-SST PET (P = 0.0002). Conclusion: 68Ga-DOTA-SST PET exhibited superior performance for lesion detection, over other functional imaging modalities, in patients with PPGLs, with the exception of polycythemia/paraganglioma syndrome. This might suggest 68Ga-DOTA-SST PET as a first-line imaging modality for the primary staging of PPGL or the restaging of PPGL with unknown genetic status.
We performed a systematic review and metaanalysis of the performance of 68Ga-DOTA-conjugated somatostatin receptor-targeting peptide (68Ga-DOTA-SST) PET in the detection of pheochromocytomas and paragangliomas (PPGLs). Methods: PubMed and Embase were searched until May 8, 2018. We included studies that reported the detection rate of 68Ga-DOTA-SST PET in patients with PPGLs. Detection rates were pooled using a random-effects model. Subgroup analyses and metaregression were performed to explore the cause of heterogeneity. Results: Thirteen studies were included for qualitative synthesis. Per-lesion detection rates of 68Ga-DOTA-SST PET were consistently higher (ranging from 92% to 100%) than other imaging modalities, including 18F-fluorohydroxyphenylalanine (18F-FDOPA) PET, 18F-FDG PET, and 123/131I-metaiodobenzylguanidine (123/131I-MIBG) scintigraphy. However, in patients with polycythemia/paraganglioma syndrome, the detection rate of 68Ga-DOTA-DOTATATE PET was 35%. Nine studies (215 patients) with no specific inclusion criteria for subtype were quantitatively synthesized. The pooled detection rate was 93% (95% confidence interval [CI], 91%-95%), which was significantly higher than that of 18F-FDOPA PET (80% [95% CI, 69%-88%]), 18F-FDG PET (74% [95% CI, 46%-91%]), and 123/131I-MIBG scan (38% [95% CI, 20%-59%], P < 0.001 for all). A greater prevalence of head and neck paragangliomas was associated with higher detection rates of 68Ga-DOTA-SST PET (P = 0.0002). Conclusion: 68Ga-DOTA-SST PET exhibited superior performance for lesion detection, over other functional imaging modalities, in patients with PPGLs, with the exception of polycythemia/paraganglioma syndrome. This might suggest 68Ga-DOTA-SST PET as a first-line imaging modality for the primary staging of PPGL or the restaging of PPGL with unknown genetic status.
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