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Comparative Study
. 2011 Sep;96(9):2779-85.
doi: 10.1210/jc.2011-0333. Epub 2011 Jul 13.

Functional imaging of SDHx-related head and neck paragangliomas: comparison of 18F-fluorodihydroxyphenylalanine, 18F-fluorodopamine, 18F-fluoro-2-deoxy-D-glucose PET, 123I-metaiodobenzylguanidine scintigraphy, and 111In-pentetreotide scintigraphy

Kathryn S King  1 , Clara C Chen, Dimitrios K Alexopoulos, Millie A Whatley, James C Reynolds, Nicholas Patronas, Alexander Ling, Karen T Adams, Paraskevi Xekouki, Howard Lando, Constantine A Stratakis, Karel Pacak
Affiliations
Comparative Study

Functional imaging of SDHx-related head and neck paragangliomas: comparison of 18F-fluorodihydroxyphenylalanine, 18F-fluorodopamine, 18F-fluoro-2-deoxy-D-glucose PET, 123I-metaiodobenzylguanidine scintigraphy, and 111In-pentetreotide scintigraphy

Kathryn S King et al. J Clin Endocrinol Metab. 2011 Sep.

Abstract

Rationale: Accurate diagnosis of head and neck paragangliomas is often complicated by biochemical silence and lack of catecholamine-associated symptoms, making accurate anatomical and functional imaging techniques essential to the diagnostic process.

Methods: Ten patients (seven SDHD, three SDHB), with a total of 26 head and neck paragangliomas, were evaluated with anatomical and functional imaging. This study compares five different functional imaging techniques [(18)F-fluorodihydroxyphenylalanine ((18)F-FDOPA) positron emission tomography (PET), (18)F-fluorodopamine ((18)F-FDA) PET/computed tomography (CT), (18)F-fluoro-2-deoxy-D-glucose ((18)F-FDG) PET/CT, (123)I-metaiodobenzylguanidine ((123)I-MIBG) scintigraphy, and (111)In-pentetreotide scintigraphy] in the localization of head and neck paragangliomas.

Results: Prospectively (18)F-FDOPA PET localized 26 of 26 lesions in the 10 patients, CT/magnetic resonance imaging localized 21 of 26 lesions, (18)F-FDG PET/CT localized 20 of 26 lesions, (111)In-pentetreotide scintigraphy localized 16 of 25 lesions, (18)F-FDA PET/CT localized 12 of 26 lesions, and (123)I-MIBG scintigraphy localized eight of 26 lesions. Differences in imaging efficacy related to genetic phenotype, even in the present small sample size, included the negativity of (18)F-FDA PET/CT and (123)I-MIBG scintigraphy in patients with SDHB mutations and the accuracy of (18)F-FDG PET/CT in all patients with SDHD mutations, as compared with the accuracy of (18)F-FDG PET/CT in only one patient with an SDHB mutation.

Conclusion: Overall, (18)F-FDOPA PET proved to be the most efficacious functional imaging modality in the localization of SDHx-related head and neck paragangliomas and may be a potential first-line functional imaging agent for the localization of these tumors.

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Figures

Fig. 1.
Fig. 1.
A, Patient 8 with bilateral carotid body tumors. Transverse sections of CT scan and the five functional imaging scans are shown. The CT scan, 18F-FDOPA PET, 18F-FDG PET/CT, and 111In-pentetreotide scintigraphy all successfully show the bilateral carotid body tumors (arrows). 18F-FDA PET/CT and 123I-MIBG scintigraphy both show only the right carotid body tumor. B, Patient 7 with right 6-mm carotid body tumor. Transverse sections of the CT scan and four functional imaging modalities and an anterior planar image of the 111In-pentetreotide scan (SPECT of this level not performed) are shown. The CT and 18F-FDOPA PET successfully demonstrate the right carotid body tumor (arrows); no other functional imaging studies demonstrate this tumor.
See this image and copyright information in PMC

References

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