68Ga-DOTA-TATE PET vs. 123I-MIBG in identifying malignant neural crest tumours.
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.
Naji
Meeran
M
Department of Nuclear Medicine, Imperial College Healthcare Trust, London, UK.
Zhao
Chunlei
C
Welsh
Sarah J
SJ
Meades
Richard
R
Win
Zarni
Z
Ferrarese
Annalisa
A
Tan
Tricia
T
Rubello
Domenico
D
Al-Nahhas
Adil
A
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
D007457:Iodine Radioisotopes; D009942:Organometallic Compounds; D019797:3-Iodobenzylguanidine; C513399:gallium Ga 68 dotatate; C108095:SDHB protein, human; D013385:Succinate Dehydrogenase