Functional characterization of nonmetastatic paraganglioma and pheochromocytoma by 18F-FDOPA PET: focus on missed lesions

被引：46

作者：

Gabriel, Sophie ^{[1
]}

Blanchet, Elise M. ^{[2
]}

Sebag, Frederic ^{[3
]}

Chen, Clara C. ^{[4
,5
]}

Fakhry, Nicolas ^{[6
]}

Deveze, Arnaud ^{[7
]}

Barlier, Anne ^{[8
]}

Morange, Isabelle ^{[9
]}

Pacak, Karel ^{[2
]}

Taieb, David ^{[1
]}

机构：

[1] Aix Marseille Univ, CERIMED, La Timone Univ Hosp, Dept Nucl Med, Marseille, France

[2] Eunice Kennedy Shriver Natl Inst Child Hlth & Hum, Program Reprod & Adult Endocrinol, NIH, Bethesda, MD USA

[3] Aix Marseille Univ, La Timone Univ Hosp, Dept Endocrine Surg, Marseille, France

[4] NIH, Dept Radiol, Ctr Clin, Bethesda, MD 20892 USA

[5] NIH, Imaging Sci Dept, Ctr Clin, Bethesda, MD 20892 USA

[6] Aix Marseille Univ, Dept Otorhinolaryngol Head & Neck Surg, La Timone Univ Hosp, Marseille, France

[7] Aix Marseille Univ, Dept Otorhinolaryngol Head & Neck Surg, North Hosp, Marseille, France

[8] Aix Marseille Univ, Concept Hosp, Lab Biochem & Mol Biol, Marseille, France

[9] Aix Marseille Univ, Dept Endocrinol, La Timone Univ Hosp, Marseille, France

来源：

CLINICAL ENDOCRINOLOGY | 2013年 / 79卷 / 02期

基金：

美国国家卫生研究院;

关键词：

POSITRON-EMISSION-TOMOGRAPHY; EXTRAADRENAL PARAGANGLIOMAS; SCINTIGRAPHY; MUTATIONS; GENE;

D O I：

10.1111/cen.12126

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims and methods To evaluate the clinical value of F-18-fluorodihydroxyphenylalanine (F-18-FDOPA) PET in relation to tumour localization and the patient's genetic status in a large series of pheochromocytoma/paraganglioma (PHEO/PGL) patients and to discuss in detail false-negative results. A retrospective study of PGL patients who were investigated with F-18-FDOPA PET or PET/CT imaging in two academic endocrine tumour centres was conducted (La Timone University Hospital, Marseilles, France and National Institutes of Health (NIH), Bethesda, MD, USA). Results One hundred sixteen patients (39.7% harbouring germline mutations in known disease susceptibility genes) were evaluated for a total of 195 PHEO/PGL foci. F-18-FDOPA PET correctly detected 179 lesions (91.8%) in 107 patients (92.2%). Lesion-based sensitivities for parasympathetic PGLs (head, neck, or anterior/middle thoracic ones), PHEOs, and extra-adrenal sympathetic (abdominal or posterior thoracic) PGLs were 98.2% [96.5% for Timone and 100% for NIH], 93.9% [93.8 and 93.9%] and 70.3% [47.1 and 90%] respectively (P < 0.001). Sympathetic (adrenal and extra-adrenal) SDHx-related PGLs were at a higher risk for negative F-18-FDOPA PET than non-SDHx-related PGLs (14/24 vs 0/62, respectively, P < 0.001). In contrast, the risk of negative F-18-FDOPA PET was lower for parasympathetic PGLs regardless of the genetic background (1/90 in SDHx vs 1/19 in non-SDHx tumours, P = 0.32). F-18-FDOPA PET failed to detect two head and neck PGLs (HNPGL), likely due to their small size, whereas most missed sympathetic PGL were larger and may have exhibited a specific F-18-FDOPA-negative imaging phenotype. F-18-FDG PET detected all the missed sympathetic lesions. Conclusions F-18-FDOPA PET appears to be a very sensitive functional imaging tool for HNPGL regardless of the genetic status of the tumours. Patients with false-negative tumours on F-18-FDOPA PET should be tested for SDHx mutations.

引用

页码：170 / 177

页数：8

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