title: Comparison of 123I-MIBG SPECT-CT and 18F-DOPA PET-CT in the evaluation of patients with known or suspected recurrent paraganglioma.
abstract: OBJECTIVE
  Detection of recurrent disease is essential for treatment planning in patients with paraganglioma. The aim of this study was to compare 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphy [whole-body and single-photon emission computed tomography (SPECT) computed tomography (CT) scanning] and fluorine-18-L-dihydroxyphenylalanine positron emission tomography CT (18F-DOPA PET-CT) in the re-staging of patients with known or suspected recurrent paraganglioma.
  
  
  METHODS
  Twelve patients with known or suspected recurrent paraganglioma after initial surgery were included in the study. 18F-DOPA PET-CT and 123I-MIBG scintigraphy (whole-body and SPECT-CT scanning) were performed in all patients; the results were compared on a per patient and a per lesion basis. Cytohistology (when available) and a combination of laboratory and imaging studies and follow-up were used as reference standard; any modification in treatment planning was recorded. In all cases recurrent disease (local or distant) was confirmed by cytohistology (four cases) or at subsequent follow-up (eight cases).
  
  
  RESULTS
  All patients had positive 18F-DOPA studies (100% sensitivity) whereas nine had positive 123I-MIBG studies (75% sensitivity; P=not significant). 18F-DOPA detected 98% of lesions, whereas 38% were detected with 123I-MIBG (P=0.04). 18F-DOPA showed more lesions than 123I-MIBG in eight patients; both techniques showed the same number of lesions in two cases whereas in two patients 123I-MIBG showed a greater number of lesions. A change in treatment planning was suggested by 18F-DOPA in one patient.
  
  
  CONCLUSIONS
  These data support the superiority of 18F-DOPA PET-CT over 123I-MIBG scintigraphy to assess disease extension in patients with recurrent paraganglioma; however, in cases with inoperable disease, 123I-MIBG maintains a unique role in allowing the selection of patients suitable for 123I-MIBG therapy.
authors.affiliation: Institute of Nuclear Medicine, Catholic University of Sacred Heart, Rome, Italy. v.rufini@rm.unicatt.it
authors.forename: Vittoria
authors.initials: V
authors.lastname: Rufini
authors.forename: Giorgio
authors.initials: G
authors.lastname: Treglia
authors.forename: Paola
authors.initials: P
authors.lastname: Castaldi
authors.forename: Germano
authors.initials: G
authors.lastname: Perotti
authors.forename: Maria Lucia
authors.initials: ML
authors.lastname: Calcagni
authors.forename: Salvatore Maria
authors.initials: SM
authors.lastname: Corsello
authors.forename: Guido
authors.initials: G
authors.lastname: Galli
authors.forename: Stefano
authors.initials: S
authors.lastname: Fanti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Giordano
mesh_terms: D019797:3-Iodobenzylguanidine; D000310:Adrenal Gland Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010235:Paraganglioma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D010236:Paraganglioma, Extra-Adrenal / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D010673:Pheochromocytoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D049268:Positron-Emission Tomography / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
chemical_list: C043437:fluorodopa F 18; D019797:3-Iodobenzylguanidine; D004295:Dihydroxyphenylalanine