Diagnostic accuracy of Ga-68-DOTANOC PET/CT imaging in pheochromocytoma

作者：Sharma Punit; Dhull Varun Singh; Arora Saurabh; Gupta Poonam; Kumar Rajeev; Durgapal Prashant; Malhotra Arun; Chumber Sunil; Ammini Ariachery C; Kumar Rakesh; Bal Chandrasekhar^*

来源：European Journal of Nuclear Medicine and Molecular Imaging, 2014, 41(3): 494-504.

DOI：10.1007/s00259-013-2598-1

• Pheochromocytoma
• 68Ga-DOTANOC
• PET/CT
• MIBG

Purpose The purpose of the present study was to evaluate the diagnostic accuracy of Ga-68-DOTANOC positron emission tomography (PET)/CT in patients with suspicion of pheochromocytoma.
Methods Data of 62 patients [age 34.3 +/- 16.1 years, 14 with multiple endocrine neoplasia type 2 (MEN2)] with clinical/biochemical suspicion of pheochromocytoma and suspicious adrenal lesion on contrast CT (n = 70), who had undergone Ga-68-DOTANOC PET/CT, were retrospectively analyzed. PET/CT images were analyzed visually as well as semiquantitatively, with measurement of maximum standardized uptake value (SUVmax), SUVmean, SUVmax/SUVliver, and SUVmean/SUVliver. Results of PET/CT were compared with I-131-metaiodobenzylguanidine (MIBG) imaging, which was available in 40 patients (45 lesions). Histopathology and/or imaging/clinical/biochemical follow-up (minimum 6 months) was used as reference standard.
Results The sensitivity, specificity, and accuracy of Ga-68-DOTANOC PET/CT was 90.4, 85, and 88.7 %, respectively, on patient-based analysis and 92, 85, and 90 %, respectively, on lesion-based analysis. Ga-68-DOTANOC PET/CT showed 100 % accuracy in patients with MEN2 syndrome and malignant pheochromocytoma. On direct comparison, lesion-based accuracy of Ga-68-DOTANOC PET/CT for pheochromocytoma was significantly higher than I-131-MIBG imaging (91.1 vs 66.6 %, p = 0.035). SUVmax was higher for pheochromocytomas than other adrenal lesions (p = 0.005), MEN2-associated vs sporadic pheochromocytoma (p = 0.012), but no difference was seen between benign vs malignant pheochromocytoma (p = 0.269).
Conclusion Ga-68-DOTANOC PET/CT shows high diagnostic accuracy in patients with suspicion of pheochromocytoma and is superior to I-131-MIBG imaging for this purpose. Best results of Ga-68-DOTANOC PET/CT are seen in patients with MEN2-associated and malignant pheochromocytoma.

• 出版日期2014-3
• 单位河北医科大学