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Teik Hin Tan,Zanariah Hussein,Fathinul Fikri Ahmad Saad,Ibrahim Lutfi Shuaib 대한핵의학회 2015 핵의학 분자영상 Vol.49 No.2
Purpose To evaluate the diagnostic performance of 68Ga- DOTATATE 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT), 18F-FDGPET/CTand 131I-MIBG scintigraphy in themapping of metastatic pheochromocytoma and paraganglioma. Materials and Methods Seventeen patients (male=8, female=9; age range, 13–68 years) with clinically proven or suspicious metastatic pheochromocytoma or paraganglioma were included in this prospective study. Twelve patients underwent all three modalities, whereas five patients underwent 68Ga-DOTATATE and 131I-MIBG without 18FFDG. A composite reference standard derived from anatomical and functional imaging findings, along with histopathological information, was used to validate the findings. Results were analysed on a per-patient and on per-lesion basis. Sensitivity and accuracy were assessed using McNemar’s test. Results On a per-patient basis, 14/17 patients were detected in 68Ga-DOTATATE, 7/17 patients in 131I-MIBG, and 10/12 patients in 18F-FDG. The sensitivity and accuracy of 68Ga- DOTATATE, 131I-MIBG and 18F-FDG were (93.3 %, 94.1 %), (46.7 %, 52.9 %) and (90.9 %, 91.7 %) respectively. On a per-lesion basis, an overall of 472 positive lesions were detected; of which 432/472 were identified by 68Ga-DOTATA TE, 74/472 by 131I-MIBG, and 154/300 (patient, n=12) by 18F-FDG. The sensitivity and accuracy of 68Ga-DOTATATE, 131I-MIBG and 18F-FDG were (91.5 %, 92.6 % p<0.0001), (15.7 %, 26.0 % p<0.0001) and (51.3 %, 57.8 % p<0.0001) respectively. Discordant lesions were demonstrated on 68Ga- DOTATATE, 131I-MIBG and 18F-FDG. Conclusions Ga-DOTATATE PET/CT shows high diagnostic accuracy than 131I-MIBG scintigraphy and 18F-FDG PET/ CT in mapping metastatic pheochromocytoma and paraganglioma.