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Functional imaging in phaeochromocytoma and neuroblastoma with 68Ga-DOTA-Tyr3-octreotide positron emission tomography and 123I-metaiodobenzylguanidine

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Abstract

Purpose

68Ga-DOTA-Tyr3-octreotide positron emission tomography (68Ga-DOTA-TOC PET) has proven to be superior to 111In-DTPA-D-Phe1-octreotide (111In-octreotide) planar scintigraphy and SPECT imaging in neuroendocrine tumours (NETs). Because of these promising results, we compared the accuracy of 123I-metaiodobenzylguanidine (123I-MIBG) imaging with PET in the diagnosis and staging of metastatic phaeochromocytoma and neuroblastoma, referring to radiological imaging as reference standard.

Methods

Three male and eight female patients (age range 3 to 68 years) with biochemically and histologically proven disease were included in this study. Three male and three female patients were suffering from phaeochromocytoma, and five female patients from neuroblastoma. Comparative evaluation included morphological imaging with CT or MRI, functional imaging with 68Ga-DOTA-TOC PET and 123I-MIBG imaging. Imaging results were analysed on a per-patient and on a per-lesion basis.

Results

On a per-patient basis, both 68Ga-DOTA-TOC and 123I-MIBG showed a sensitivity of 100%, when compared with anatomical imaging. In phaeochromocytoma patients, on a per-lesion basis, the sensitivity of 68Ga-DOTA-TOC was 91.7% and that of 123I-MIBG was 63.3%. In neuroblastoma patients, on a per-lesion basis, the sensitivity of 68Ga-DOTA-TOC was 97.2% and that of 123I-MIBG was 90.7%. Overall, in this patient cohort, 68Ga-DOTA-TOC PET identified 257 lesions, anatomical imaging identified 216 lesions, and 123I-MIBG identified only 184 lesions. In this patient group, the overall sensitivity of 68Ga-DOTA-TOC PET on a lesion basis was 94.4% (McNemar p<0.0001) and that of 123I-MIBG was 76.9% (McNemar p<0.0001).

Conclusion

Our analysis in this relatively small patient cohort indicates that 68Ga-DOTA-TOC PET may be superior to 123I-MIBG gamma-scintigraphy and even to the reference CT/MRI technique in providing particularly valuable information for pretherapeutic staging of phaeochromocytoma and neuroblastoma.

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Acknowledgments

We are grateful to Martin Knoflach from the Department of Radiology and Mathias Wochinz from the Department of Nuclear Medicine (Innsbruck Medical University, Austria) for their work on the project. The authors thank Regina Figl for her editorial assistance.

Conflict of interest

None.

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Authors and Affiliations

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

    Alexander Kroiss, Daniel Putzer, Christian Uprimny, Clemens Decristoforo, Michael Gabriel, Boris Warwitz, Dietmar Waitz, Dorota Kendler & Irene Johanna Virgolini

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

    Wolfram Santner & Christof Kranewitter

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  1. Alexander Kroiss
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  2. Daniel Putzer
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Correspondence to Alexander Kroiss.

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Kroiss, A., Putzer, D., Uprimny, C. et al. Functional imaging in phaeochromocytoma and neuroblastoma with 68Ga-DOTA-Tyr3-octreotide positron emission tomography and 123I-metaiodobenzylguanidine. Eur J Nucl Med Mol Imaging 38, 865–873 (2011). https://doi.org/10.1007/s00259-010-1720-x

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  • DOI: https://doi.org/10.1007/s00259-010-1720-x

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