Comparison of 18F-Fluoro-L-DOPA, 18F-Fluoro-Deoxyglucose, and 18F-Fluorodopamine PET and 123I-MIBG Scintigraphy in the Localization of Pheochromocytoma and Paraganglioma

被引:289
作者
Timmers, Henri J. L. M. [1 ,2 ]
Chen, Clara C. [3 ]
Carrasquillo, Jorge A. [3 ,5 ]
Whatley, Millie [3 ]
Ling, Alexander [4 ]
Havekes, Bastiaan [2 ,6 ]
Eisenhofer, Graeme [7 ]
Martiniova, Lucia [2 ]
Adams, Karen T. [2 ]
Pacak, Karel [2 ]
机构
[1] Radboud Univ Nijmegen, Med Ctr, Dept Endocrinol, NL-6500 HB Nijmegen, Netherlands
[2] Eunice Kennedy Shriver Natl Inst Child Hlth & Hum, Reprod & Adult Endocrinol Program, NIH, Bethesda, MD 20892 USA
[3] NIH, Dept Nucl Med, Bethesda, MD 20892 USA
[4] NIH, Dept Diagnost Radiol, Warren G Magnuson Clin Ctr, Bethesda, MD 20892 USA
[5] Mem Sloan Kettering Canc Ctr, Nucl Med Sect, Dept Radiol, New York, NY 10021 USA
[6] Univ Hosp Maastricht, Dept Internal Med, Div Endocrinol, NL-6202 AZ Maastricht, Netherlands
[7] Univ Dresden, Dept Med, D-01307 Dresden, Germany
基金
美国国家卫生研究院;
关键词
POSITRON-EMISSION-TOMOGRAPHY; ENDOCRINE NEOPLASIA TYPE-2; HIPPEL-LINDAU-SYNDROME; F-18 DOPA PET; NEUROENDOCRINE TUMORS; METASTATIC PHEOCHROMOCYTOMA; MIBG SCINTIGRAPHY; METAIODOBENZYLGUANIDINE; I-123-METAIODOBENZYLGUANIDINE; TRANSPORTERS;
D O I
10.1210/jc.2009-1248
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Context: Besides I-123-metaiodobenzylguanidine (MIBG), positron emission tomography (PET) agents are available for the localization of paraganglioma (PGL), including F-18-3,4-dihydroxyphenylalanine (DOPA), F-18-fluoro-2-deoxy-D-glucose (F-18-FDG), and F-18-fluorodopamine (F-18-FDA). Objective: The objective of the study was to establish the optimal approach to the functional imaging of PGL and examine the link between genotype-specific tumor biology and imaging. Design: This was a prospective observational study. Intervention: There were no interventions. Patients: Fifty-two patients (28 males, 24 females, aged 46.8 +/- 14.2 yr): 20 with nonmetastatic PGL (11 adrenal), 28 with metastatic PGL (13 adrenal), and four in whom PGL was ruled out; 22 PGLs were of the succinate dehydrogenase subunit B (SDHB) genotype. Main Outcome Measures: Sensitivity of F-18-DOPA, F-18-FDG, and F-18-FDA PET, I-123-MIBG scintigraphy, computed tomography (CT), and magnetic resonance imaging (MRI) for the localization of PGL were measured. Results: Sensitivities for localizing nonmetastatic PGL were 100% for CT and/or MRI, 81% for F-18-DOPA PET, 88% for F-18-FDG PET/CT, 78% for F-18-FDA PET/CT, and 78% for I-123-MIBG scintigraphy. For metastatic PGL, sensitivity in reference to CT/MRI was 45% for F-18-DOPA PET, 74% for F-18-FDG PET/CT, 76% for F-18-FDA PET/CT, and 57% for I-123-MIBG scintigraphy. In patients with SDHB metastatic PGL, F-18-FDA and F-18-FDG have a higher sensitivity (82 and 83%) than I-123-MIBG (57%) and F-18-DOPA (20%). Conclusions: F-18-FDA PET/CT is the preferred technique for the localization of the primary PGL and to rule out metastases. Second best, equal alternatives are F-18-DOPA PET and I-123-MIBG scintigraphy. For patients with known metastatic PGL, we recommend F-18-FDA PET in patients with an unknown genotype, F-18-FDG or F-18-FDA PET in SDHB mutation carriers, and F-18-DOPA or F-18-FDA PET in non-SDHB patients. (J Clin Endocrinol Metab 94: 4757-4767, 2009)
引用
收藏
页码:4757 / 4767
页数:11
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