6-18F-Fluoro-L-Dihydroxyphenylalanine Positron Emission Tomography Is Superior to 123I-Metaiodobenzyl-Guanidine Scintigraphy in the Detection of Extraadrenal and Hereditary Pheochromocytomas and Paragangliomas: with Vesicular Monoamine Transporter Expression

被引:97
作者
Fottner, C. [1 ]
Helisch, A. [2 ]
Anlauf, M. [7 ]
Rossmann, H. [4 ]
Musholt, T. J. [5 ]
Kreft, A. [6 ]
Schadmand-Fischer, S. [3 ]
Bartenstein, P. [8 ]
Lackner, K. J. [4 ]
Kloeppel, G. [9 ]
Schreckenberger, M. [2 ]
Weber, M. M.
机构
[1] Johannes Gutenberg Univ Mainz, Med Clin 1, Dept Endocrinol & Metab, D-55131 Mainz, Germany
[2] Johannes Gutenberg Univ Mainz, Dept Nucl Med, D-55131 Mainz, Germany
[3] Johannes Gutenberg Univ Mainz, Dept Radiol, D-55131 Mainz, Germany
[4] Johannes Gutenberg Univ Mainz, Inst Clin Chem, D-55131 Mainz, Germany
[5] Johannes Gutenberg Univ Mainz, Sect Endocrine Surg, D-55131 Mainz, Germany
[6] Johannes Gutenberg Univ Mainz, Inst Pathol, D-55131 Mainz, Germany
[7] Univ Dusseldorf, Inst Pathol, D-40225 Dusseldorf, Germany
[8] Univ Munich, Dept Nucl Med, D-80539 Munich, Germany
[9] Tech Univ, Inst Pathol, D-80802 Munich, Germany
关键词
METASTATIC PHEOCHROMOCYTOMA; NEUROENDOCRINE TUMORS; 2; ISOFORMS; PET; LOCALIZATION;
D O I
10.1210/jc.2009-2352
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Context: Pheochromocytomas (PHEOs) and paragangliomas (PGLs) may be better detected by F-18-fluorodihydroxyphenylalanine-positron emission tomography (FDOPA-PET) than I-123-metaiodobenzyl-guanidine (123-I-MIBG) scintigraphy. Objective: The objective of the study was to correlate functional imaging results with immunohistochemical, molecular-genetic, and biochemical findings. Design and Setting: Thirty consecutive patients with suspected PHEO/PGL presenting at a tertiary referral centre were investigated in a prospective study. Patients: Twenty-five patients had confirmed PHEO/PGL. Thirteen of 25 patients had a hereditary PHEO/PGL syndrome (two multiple endocrine neoplasia II, six succinate dehydrogenase complex, subunit D, two succinate dehydrogenase complex, subunit B, one von Hippel Lindau tumor suppressor protein, two Neurofibromatosis-1), and 12 of 25 were classified as sporadic. Five patients had hormonally inactive adrenal incidentalomas. Main Outcome Measures: In all patients computed tomography scan and/or magnetic resonance imaging as well as both 123-I-MIBG scintigraphy and FDOPA-PET were performed. Resected tumors were examined by immunohistochemistry for expression of the vesicular monoamine transporter (VMAT)-1 and -2 and other markers. Results: A total of 64 lesions were found with both functional imaging modalities. FDOPA-PET detected 62 lesions, whereas only 34 lesions were detected by 123-I-MIBG scintigraphy. This resulted in an overall sensitivity and specificity for FDOPA-PET of 98 and 100% and for MIBG of 53 and 91%, respectively. Comparable sensitivities were found for adrenal and extraadrenal abdominal lesions (94 vs. 97%), whereas in thoracic/cervical lesions, the sensitivity for 123-I-MIBG scintigraphy (15%) was inferior to that of FDOPA-PET imaging (100%). Immunohistochemistry demonstrated a lack of VMAT-1 expression in all MIBG-negative tumors. Clinical predictors for MIBG negativity were a predominant norepinephrine/normetanephrine secretion, an age less than 45 yr, and a hereditary cause. Conclusion: FDOPA-PET is superior to 123-I-MIBG scintigraphy in patients with extraadrenal, predominantly noradrenaline-secreting, and hereditary types of PHEO/PGL. The lack of VMAT-1 expression predicts negativity for MIBG-scintigraphy. (J Clin Endocrinol Metab 95: 2800-2810, 2010)
引用
收藏
页码:2800 / 2810
页数:11
相关论文
共 34 条
[1]   Expression of the two isoforms of the vesicular monoamine transporter (VMAT1 and VMAT2) in the endocrine pancreas and pancreatic endocrine tumors [J].
Anlauf, M ;
Eissele, R ;
Schäfer, MKH ;
Eiden, LE ;
Arnold, R ;
Pauser, U ;
Klöppel, G ;
Weihe, E .
JOURNAL OF HISTOCHEMISTRY & CYTOCHEMISTRY, 2003, 51 (08) :1027-1040
[2]   Imaging of pheochromocytoma and paraganghoma [J].
Brink, I ;
Hoegerle, S ;
Klisch, J ;
Bley, TA .
FAMILIAL CANCER, 2005, 4 (01) :61-68
[3]   Distinct pharmacological properties and distribution in neurons and endocrine cells of two isoforms of the human vesicular monoamine transporter [J].
Erickson, JD ;
Schafer, MKH ;
Bonner, TI ;
Eiden, LE ;
Weihe, E .
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 1996, 93 (10) :5166-5171
[4]   Diagnosing patients with hereditary paraganglial tumours [J].
Erlic, Zoran ;
Neumann, Hartmut P. H. .
LANCET ONCOLOGY, 2009, 10 (08) :741-741
[5]   6-[F-18]Fluoro-L-Dihydroxyphenylalanine Positron Emission Tomography Is Superior to Conventional Imaging with 123I-Metaiodobenzylguanidine Scintigraphy, Computer Tomography, and Magnetic Resonance Imaging in Localizing Tumors Causing Catecholamine Excess [J].
Fiebrich, Helle-Brit ;
Brouwers, Adrienne H. ;
Kerstens, Michiel N. ;
Pijl, Milan E. J. ;
Kema, Ido P. ;
de Jong, Johan R. ;
Jager, Pieter L. ;
Elsinga, Philip H. ;
Dierckx, Rudi A. J. O. ;
van der Wal, Jacqueline E. ;
Sluiter, Wim J. ;
de Vries, Elisabeth G. E. ;
Links, Thera P. .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2009, 94 (10) :3922-3930
[6]  
Havekes B, 2008, Q J NUCL MED MOL IM, V52, P419
[7]   Pheochromocytoma [J].
Bas Havekes ;
Karel Pacak .
Nature Clinical Practice Cardiovascular Medicine, 2008, 5 (2) :E1-E1
[8]   New imaging approaches to phaeochromocytomas and paragangliomas [J].
Havekes, Bas ;
King, Kathryn ;
Lai, Edwin W. ;
Romijn, Johannes A. ;
Corssmit, Eleonora P. M. ;
Pacak, Karel .
CLINICAL ENDOCRINOLOGY, 2010, 72 (02) :137-145
[9]   18F-DOPA positron emission tomography for the detection of glomus tumours [J].
Hoegerle, S ;
Ghanem, N ;
Altehoefer, C ;
Schipper, J ;
Brink, I ;
Moser, E ;
Neumann, HPH .
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2003, 30 (05) :689-694
[10]   Pheochromocytomas:: Detection with 18F DOPA whole-body PET -: Initial results [J].
Hoegerle, S ;
Nitzsche, E ;
Altehoefer, C ;
Ghanem, N ;
Manz, T ;
Brink, I ;
Reincke, M ;
Moser, E ;
Neumann, HPH .
RADIOLOGY, 2002, 222 (02) :507-512