title: 68Ga-DOTA-TATE PET vs. 123I-MIBG in identifying malignant neural crest tumours.
abstract: OBJECTIVE
  We aimed to compare imaging with (123)I-MIBG and (68)Ga-DOTA-TATE in neural crest tumours (NCT) to see if the latter could offer more advantage in detecting extra lesions and have higher sensitivity for malignant lesions.
  
  
  METHODS
  We retrospectively reviewed 12 patients (M = 10, F = 2; age range 20-71 years) with NCT (phaeochromocytomas = 7, paragangliomas = 4, medullary thyroid cancer = 1) who underwent both (68)Ga-DOTA-TATE positron emission tomography (PET) or PET/computed tomography (CT) and (123)I-MIBG single-photon emission computed tomography within 6 months. Visual assessment of all lesions and measurement of target/non-target (T/N) ratio in selected lesions were performed. Five patients (aged 50 or less) had SDHB screening results correlated with imaging results of both radiopharmaceuticals. All patients had contrast-enhanced CT and/or other cross-sectional imaging.
  
  
  RESULTS
  (68)Ga-DOTA-TATE PET showed tumour lesions in ten out of 12 patients with confirmed disease, while (123)I-MIBG showed lesions in five out of 12 patients. In one patient, both (68)Ga-DOTA-TATE PET and (123)I-MIBG were negative, but CT, magnetic resonance imaging, and 2-deoxy-2-[(18)F]fluoro-D-glucose PET scans identified a lesion in the thorax. (68)Ga-DOTA-TATE and (123)I-MIBG detected a total of 30 lesions, of which 29/30 were positive with (68)Ga-DOTA-TATE and 7/30 with (123)I-MIBG. We also found higher incidence of SDHB positive results in patients with positive (68)Ga-DOTA-TATE.
  
  
  CONCLUSIONS
  Our limited data suggest that (68)Ga-DOTA-TATE is a better imaging agent for NCT and detects significantly more lesions with higher T/N ratio compared to (123)I-MIBG. (68)Ga-DOTA-TATE was more likely to detect malignant lesions as indicated by correlating imaging results with SDHB screening.
authors.affiliation: Department of Nuclear Medicine, Imperial College Healthcare Trust, London, UK.
authors.forename: Meeran
authors.initials: M
authors.lastname: Naji
authors.forename: Chunlei
authors.initials: C
authors.lastname: Zhao
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Welsh
authors.forename: Richard
authors.initials: R
authors.lastname: Meades
authors.forename: Zarni
authors.initials: Z
authors.lastname: Win
authors.forename: Annalisa
authors.initials: A
authors.lastname: Ferrarese
authors.forename: Tricia
authors.initials: T
authors.lastname: Tan
authors.forename: Domenico
authors.initials: D
authors.lastname: Rubello
authors.forename: Adil
authors.initials: A
authors.lastname: Al-Nahhas
mesh_terms: D019797:3-Iodobenzylguanidine; D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D009942:Organometallic Compounds; D010235:Paraganglioma / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography / Q000379:methods*; D012189:Retrospective Studies; D013385:Succinate Dehydrogenase / Q000235:genetics; D055815:Young Adult
chemical_list: D007457:Iodine Radioisotopes; D009942:Organometallic Compounds; D019797:3-Iodobenzylguanidine; C513399:gallium Ga 68 dotatate; C108095:SDHB protein, human; D013385:Succinate Dehydrogenase