Prospective comparison of (68)Ga-DOTATATE and (18)F-FDOPA PET/CT in patients with various pheochromocytomas and paragangliomas with emphasis on sporadic cases

Aurélien Archier^{1

2

3}, Arthur Varoquaux⁴, Philippe Garrigue^{1

5}, Marion Montava⁶, Carole Guerin⁷, Sophie Gabriel^{1

2}, Eva Beschmout⁴, Isabelle Morange⁸, Nicolas Fakhry⁶, Frédéric Castinetti⁸, Frédéric Sebag⁷, Anne Barlier⁹, Anderson Loundou¹⁰, Benjamin Guillet^{1

5}, Karel Pacak¹¹, David Taïeb^{12

13

14}

Affiliations

¹ Department of Nuclear Medicine, La Timone & North University Hospital, Aix-Marseille University, Marseille, France.
² European Center for Research in Medical Imaging, Aix-Marseille University, Marseille, France.
³ Institut Paoli-Calmettes, Inserm UMR1068 Marseille Cancerology Research Center, Marseille, France.
⁴ Department of Medical Imaging, Conception Hospital, Aix-Marseille University, Marseille, France.
⁵ Department of Radiopharmacy, La Timone & North University Hospital, Aix-Marseille University, Marseille, France.
⁶ Department of Otorhinolaryngology-Head and Neck Surgery, Conception Hospital, Aix-Marseille University, Marseille, France.
⁷ Department of Endocrine Surgery, Conception Hospital, Aix-Marseille University, Marseille, France.
⁸ Department of Endocrinology, Conception Hospital, Aix-Marseille University, Marseille, France.
⁹ Laboratory of Biochemistry and Molecular Biology, Conception Hospital, Aix-Marseille, University, Marseille, France.
¹⁰ Department of Public Health, Aix-Marseille University, Marseille, France.
¹¹ Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health, Bethesda, MD, 20892, USA.
¹² Department of Nuclear Medicine, La Timone & North University Hospital, Aix-Marseille University, Marseille, France. david.taieb@ap-hm.fr.
¹³ European Center for Research in Medical Imaging, Aix-Marseille University, Marseille, France. david.taieb@ap-hm.fr.
¹⁴ Institut Paoli-Calmettes, Inserm UMR1068 Marseille Cancerology Research Center, Marseille, France. david.taieb@ap-hm.fr.

PMID: 26637204
DOI: 10.1007/s00259-015-3268-2

Clinical Trial

Prospective comparison of (68)Ga-DOTATATE and (18)F-FDOPA PET/CT in patients with various pheochromocytomas and paragangliomas with emphasis on sporadic cases

Aurélien Archier et al. Eur J Nucl Med Mol Imaging. 2016 Jul.

. 2016 Jul;43(7):1248-57.

doi: 10.1007/s00259-015-3268-2. Epub 2015 Dec 5.

Authors

Affiliations

¹ Department of Nuclear Medicine, La Timone & North University Hospital, Aix-Marseille University, Marseille, France.
² European Center for Research in Medical Imaging, Aix-Marseille University, Marseille, France.
³ Institut Paoli-Calmettes, Inserm UMR1068 Marseille Cancerology Research Center, Marseille, France.
⁴ Department of Medical Imaging, Conception Hospital, Aix-Marseille University, Marseille, France.
⁵ Department of Radiopharmacy, La Timone & North University Hospital, Aix-Marseille University, Marseille, France.
⁶ Department of Otorhinolaryngology-Head and Neck Surgery, Conception Hospital, Aix-Marseille University, Marseille, France.
⁷ Department of Endocrine Surgery, Conception Hospital, Aix-Marseille University, Marseille, France.
⁸ Department of Endocrinology, Conception Hospital, Aix-Marseille University, Marseille, France.
⁹ Laboratory of Biochemistry and Molecular Biology, Conception Hospital, Aix-Marseille, University, Marseille, France.
¹⁰ Department of Public Health, Aix-Marseille University, Marseille, France.
¹¹ Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD), National Institutes of Health, Bethesda, MD, 20892, USA.
¹² Department of Nuclear Medicine, La Timone & North University Hospital, Aix-Marseille University, Marseille, France. david.taieb@ap-hm.fr.
¹³ European Center for Research in Medical Imaging, Aix-Marseille University, Marseille, France. david.taieb@ap-hm.fr.
¹⁴ Institut Paoli-Calmettes, Inserm UMR1068 Marseille Cancerology Research Center, Marseille, France. david.taieb@ap-hm.fr.

PMID: 26637204
DOI: 10.1007/s00259-015-3268-2

Abstract

Purpose: Pheochromocytomas/paragangliomas (PHEOs/PGLs) overexpress somatostatin receptors and recent studies have already shown excellent results in the localization of these tumors using (68)Ga-labeled somatostatin analogs ((68)Ga-DOTA-SSA), especially in patients with germline succinate dehydrogenase subunit B gene (SDHB) mutations and head and neck PGLs (HNPGLs). The value of (68)Ga-DOTA-SSA has to be established in sporadic cases, including PHEOs. Thus, the aim of this study was to compare (68)Ga-DOTATATE PET/CT, (18)F-FDOPA PET/CT, and conventional imaging in patients with various PHEOs/PGLs with a special emphasis on sporadic cases, including those located in the adrenal gland.

Design: (68)Ga-DOTATATE, (18)F-FDOPA PET/CT, and conventional imaging (contrast-enhanced CT and MRI with MR angiography sequences) were prospectively performed in 30 patients (8 with SDHD mutations, 1 with a MAX mutation and 21 sporadic cases) with PHEO/PGL at initial diagnosis or relapse.

Results: The patient-based sensitivities were 93 % (28/30), 97 % (29/30), and 93 % (28/30) for (68)Ga-DOTATATE PET/CT, (18)F-FDOPA PET/CT, and conventional imaging, respectively. The lesion-based sensitivities were 93 % (43/46), 89 % (41/46), and 76 % (35/46) for (68)Ga-DOTATATE PET/CT, (18)F-FDOPA PET/CT, and conventional imaging respectively (p = 0.042). (68)Ga-DOTATATE PET/CT detected a higher number of HNPGLs (30/30) than (18)F-FDOPA PET/CT (26/30; p = 0.112) and conventional imaging (24/30; p = 0.024). (68)Ga-DOTATATE PET/CT missed two PHEOs of a few millimeters in size and a large recurrent PHEO. One lesion was considered false-positive on (68)Ga-DOTATATE PET/CT and corresponded to a typical focal lesion of fibrous dysplasia on MRI. Among the 11 lesions missed by conventional imaging, 7 were detected by conventional imaging with knowledge of the PET results (4 HNPGLs, 2 LNs, and 1 recurrent PHEO).

Conclusion: (68)Ga-DOTATATE PET/CT is the most sensitive tool in the detection of HNPGLs, especially SDHD-related tumors, which may be very small and fail to concentrate sufficient (18)F-FDOPA. The present study further expands the use of (68)Ga-DOTATATE for all patients with HNPGLs, regardless of their genotype. (68)Ga-DOTATATE PET/CT may be inferior to (18)F-FDOPA PET/CT in the detection PHEOs.

Keywords: Gallium radioisotopes; Neuroendocrine; Paragangliomas; Positron emission tomography; Somatostatin.

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References

1. J Nucl Med. 1998 Feb;39(2):238-40 - PubMed
1. Eur J Nucl Med Mol Imaging. 2013 Apr;40(4):514-23 - PubMed
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Prospective comparison of (68)Ga-DOTATATE and (18)F-FDOPA PET/CT in patients with various pheochromocytomas and paragangliomas with emphasis on sporadic cases

Affiliations

Prospective comparison of (68)Ga-DOTATATE and (18)F-FDOPA PET/CT in patients with various pheochromocytomas and paragangliomas with emphasis on sporadic cases

Authors

Affiliations

Abstract

References

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Full Text Sources

Medical

Research Materials

Miscellaneous