title: Functional imaging in phaeochromocytoma and neuroblastoma with 68Ga-DOTA-Tyr 3-octreotide positron emission tomography and 123I-metaiodobenzylguanidine.
abstract: OBJECTIVE
  (68)Ga-DOTA-Tyr(3)-octreotide positron emission tomography ((68)Ga-DOTA-TOC PET) has proven to be superior to (111)In-DTPA-D-Phe(1)-octreotide ((111)In-octreotide) planar scintigraphy and SPECT imaging in neuroendocrine tumours (NETs). Because of these promising results, we compared the accuracy of (123)I-metaiodobenzylguanidine ((123)I-MIBG) imaging with PET in the diagnosis and staging of metastatic phaeochromocytoma and neuroblastoma, referring to radiological imaging as reference standard.
  
  
  METHODS
  Three male and eight female patients (age range 3 to 68 years) with biochemically and histologically proven disease were included in this study. Three male and three female patients were suffering from phaeochromocytoma, and five female patients from neuroblastoma. Comparative evaluation included morphological imaging with CT or MRI, functional imaging with (68)Ga-DOTA-TOC PET and (123)I-MIBG imaging. Imaging results were analysed on a per-patient and on a per-lesion basis.
  
  
  RESULTS
  On a per-patient basis, both (68)Ga-DOTA-TOC and (123)I-MIBG showed a sensitivity of 100%, when compared with anatomical imaging. In phaeochromocytoma patients, on a per-lesion basis, the sensitivity of (68)Ga-DOTA-TOC was 91.7% and that of (123)I-MIBG was 63.3%. In neuroblastoma patients, on a per-lesion basis, the sensitivity of (68)Ga-DOTA-TOC was 97.2% and that of (123)I-MIBG was 90.7%. Overall, in this patient cohort, (68)Ga-DOTA-TOC PET identified 257 lesions, anatomical imaging identified 216 lesions, and (123)I-MIBG identified only 184 lesions. In this patient group, the overall sensitivity of (68)Ga-DOTA-TOC PET on a lesion basis was 94.4% (McNemar p<0.0001) and that of (123)I-MIBG was 76.9% (McNemar p<0.0001).
  
  
  CONCLUSIONS
  Our analysis in this relatively small patient cohort indicates that (68)Ga-DOTA-TOC PET may be superior to (123)I-MIBG gamma-scintigraphy and even to the reference CT/MRI technique in providing particularly valuable information for pretherapeutic staging of phaeochromocytoma and neuroblastoma.
authors.affiliation: Department of Nuclear Medicine, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria. alexander.kroiss@i-med.ac.at
authors.forename: Alexander
authors.initials: A
authors.lastname: Kroiss
authors.forename: Daniel
authors.initials: D
authors.lastname: Putzer
authors.forename: Christian
authors.initials: C
authors.lastname: Uprimny
authors.forename: Clemens
authors.initials: C
authors.lastname: Decristoforo
authors.forename: Michael
authors.initials: M
authors.lastname: Gabriel
authors.forename: Wolfram
authors.initials: W
authors.lastname: Santner
authors.forename: Christof
authors.initials: C
authors.lastname: Kranewitter
authors.forename: Boris
authors.initials: B
authors.lastname: Warwitz
authors.forename: Dietmar
authors.initials: D
authors.lastname: Waitz
authors.forename: Dorota
authors.initials: D
authors.lastname: Kendler
authors.forename: Irene Johanna
authors.initials: IJ
authors.lastname: Virgolini
mesh_terms: D019797:3-Iodobenzylguanidine; D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000000981:diagnostic imaging* / Q000473:pathology; D015282:Octreotide / Q000031:analogs & derivatives*; D009942:Organometallic Compounds; D010673:Pheochromocytoma / Q000000981:diagnostic imaging* / Q000473:pathology; D049268:Positron-Emission Tomography / Q000379:methods* / Q000592:standards; D012015:Reference Standards; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: C550726:68Ga-octreotide, DOTA(0)-Tyr(3)-; D009942:Organometallic Compounds; D019797:3-Iodobenzylguanidine; D015282:Octreotide