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Diagnostic performance of 18F-dihydroxyphenylalanine positron emission tomography in patients with paraganglioma: a meta-analysis

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Abstract

Purpose

The aim of this study was to systematically review and conduct a meta-analysis of published data about the diagnostic performance of 18F-dihydroxyphenylalanine (DOPA) positron emission tomography (PET) in patients with paraganglioma (PG).

Methods

A comprehensive computer literature search of studies published through 30 June 2011 regarding 18F-DOPA PET or PET/computed tomography (PET/CT) in patients with PG was performed in PubMed/MEDLINE, Embase and Scopus databases. Pooled sensitivity and specificity of 18F-DOPA PET or PET/CT in patients with PG on a per patient- and on a per lesion-based analysis were calculated. The area under the receiver-operating characteristic (ROC) curve was calculated to measure the accuracy of 18F-DOPA PET or PET/CT in patients with PG. Furthermore, a sub-analysis taking into account the different genetic mutations in PG patients was also performed.

Results

Eleven studies comprising 275 patients with suspected PG were included in this meta-analysis. The pooled sensitivity of 18F-DOPA PET and PET/CT in detecting PG was 91% [95% confidence interval (CI) 87–94%] on a per patient-based analysis and 79% (95% CI 76–81%) on a per lesion-based analysis. The pooled specificity of 18F-DOPA PET and PET/CT in detecting PG was 95% (95% CI 86–99%) on a per patient-based analysis and 95% (95% CI 84–99%) on a per lesion-based analysis. The area under the ROC curve was 0.95 on a per patient- and 0.94 on a per lesion-based analysis. Heterogeneity between the studies about sensitivity of 18F-DOPA PET or PET/CT was found. A significant increase in sensitivity of 18F-DOPA PET or PET/CT was observed when a sub-analysis excluding patients with succinate dehydrogenase subunit B (SDHB) gene mutations was performed.

Conclusion

In patients with suspected PG 18F-DOPA PET or PET/CT demonstrated high sensitivity and specificity. 18F-DOPA PET or PET/CT are accurate methods in this setting. Nevertheless, possible sources of false-negative results should be kept in mind. Furthermore, SDHB gene mutations could influence 18F-DOPA PET or PET/CT diagnostic performance.

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Authors and Affiliations

  1. Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Largo Gemelli, 8, 00168, Rome, Italy

    Giorgio Treglia, Fabrizio Cocciolillo, Paola Castaldi, Vittoria Rufini & Alessandro Giordano

  2. Institute of Hygiene, Catholic University of the Sacred Heart, Rome, Italy

    Chiara de Waure, Francesco Di Nardo & Maria Rosaria Gualano

Authors
  1. Giorgio Treglia
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  2. Fabrizio Cocciolillo
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  3. Chiara de Waure
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  4. Francesco Di Nardo
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  5. Maria Rosaria Gualano
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  6. Paola Castaldi
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  7. Vittoria Rufini
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  8. Alessandro Giordano
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Correspondence to Giorgio Treglia.

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Treglia, G., Cocciolillo, F., de Waure, C. et al. Diagnostic performance of 18F-dihydroxyphenylalanine positron emission tomography in patients with paraganglioma: a meta-analysis. Eur J Nucl Med Mol Imaging 39, 1144–1153 (2012). https://doi.org/10.1007/s00259-012-2087-y

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  • DOI: https://doi.org/10.1007/s00259-012-2087-y

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