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68Ga-DOTATOC PET/CT provides accurate tumour extent in patients with extraadrenal paraganglioma compared to 123I-MIBG SPECT/CT

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to compare the accuracy of 123I-MIBG SPECT/CT with that of 68Ga-DOTATOC PET/CT for staging extraadrenal paragangliomas (PGL) using both functional and anatomical images (i.e. combined cross-sectional imaging) as the reference standards.

Methods

The study included three men and seven women (age range 26 to 73 years) with anatomical and/or histologically proven disease. Three patients had either metastatic head and neck PGL (HNPGL) or multifocal extraadrenal PGL, and seven patients had nonmetastatic extraadrenal disease. Comparative evaluation included morphological imaging with CT, functional imaging with 68Ga-DOTATOC PET, and 123I-MIBG imaging. The imaging results were analysed on a per-patient and on a per-lesion basis.

Results

On a per-patient basis, the detection rate of 68Ga-DOTATOC PET was 100 %, whereas that of planar 123I-MIBG imaging was 10.0 % and with SPECT/CT 20.0 % for both nonmetastatic and metastatic/multifocal extraadrenal PGL. On a per-lesion basis, the overall sensitivity of 68Ga-DOTATOC PET was 100 % (McNemar p < 0.5), that of planar 123I-MIBG imaging was 3.4 % (McNemar p < 0.001) and that of SPECT/CT was 6.9 % (McNemar p < 0.001). Both 68Ga-DOTATOC PET and anatomical imaging identified 27 lesions. Planar 123I-MIBG imaging identified only one lesion, and SPECT/CT two lesions. Two additional lesions were detected by 68Ga-DOTATOC PET but not by either 123I-MIBG or CT imaging.

Conclusion

Our analysis in this patient cohort indicated that 68Ga-DOTATOC PET/CT is superior to 123I-MIBG SPECT/CT, particularly in head and neck and bone lesions, and provides valuable information for staging extraadrenal PGL, particularly in patients with surgically inoperable tumours or multifocal/malignant disease.

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Acknowledgments

We are grateful to Mathias Wochinz and Boris Warwitz (Department of Nuclear Medicine, Innsbruck Medical University) for their work on the project. We thank Dr. Claudia Goetsch (Department of Internal Medicine I, Innsbruck Medical University) and Dr. Lydia Posch (Department of Vascular Surgery, Innsbruck Medical University) for their support on this project. We also thank Harald Kühschelm for statistical advice, and Philipp Heinricher and Dr. Cherise Guess (Department of Scientific Editing, St. Jude Children’s Research Hospital) for editorial assistance.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria

    Alexander Kroiss, Christian Uprimny, Ruth Madleitner, Bernhard Nilica & Irene Johanna Virgolini

  2. Department of Radiological Sciences, St. Jude Children’s Research Hospital, Memphis, TN, USA

    Barry Lynn Shulkin

  3. Department of Vascular Surgery, Innsbruck Medical University, Innsbruck, Austria

    Andreas Frech & Gustav Fraedrich

  4. Department of Internal Medicine I, Innsbruck Medical University, Innsbruck, Austria

    Rudolf Wolfgang Gasser

  5. Department of Otorhinolaryngology, Innsbruck Medical University, Innsbruck, Austria

    Christoph Url

  6. Department of Radiology, Innsbruck Medical University, Innsbruck, Austria

    Kurt Gautsch

  7. Department of Otorhinolaryngology, State Clinic, St. Poelten, Austria

    Georg Mathias Sprinzl

  8. Department of Internal Medicine V, Innsbruck Medical University, Innsbruck, Austria

    Guenther Gastl

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  1. Alexander Kroiss
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Correspondence to Alexander Kroiss.

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Kroiss, A., Shulkin, B.L., Uprimny, C. et al. 68Ga-DOTATOC PET/CT provides accurate tumour extent in patients with extraadrenal paraganglioma compared to 123I-MIBG SPECT/CT. Eur J Nucl Med Mol Imaging 42, 33–41 (2015). https://doi.org/10.1007/s00259-014-2892-6

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  • DOI: https://doi.org/10.1007/s00259-014-2892-6

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