title: Functional imaging of SDHx-related head and neck paragangliomas: comparison of 18F-fluorodihydroxyphenylalanine, 18F-fluorodopamine, 18F-fluoro-2-deoxy-D-glucose PET, 123I-metaiodobenzylguanidine scintigraphy, and 111In-pentetreotide scintigraphy.
abstract: BACKGROUND
  Accurate diagnosis of head and neck paragangliomas is often complicated by biochemical silence and lack of catecholamine-associated symptoms, making accurate anatomical and functional imaging techniques essential to the diagnostic process.
  
  
  METHODS
  Ten patients (seven SDHD, three SDHB), with a total of 26 head and neck paragangliomas, were evaluated with anatomical and functional imaging. This study compares five different functional imaging techniques [(18)F-fluorodihydroxyphenylalanine ((18)F-FDOPA) positron emission tomography (PET), (18)F-fluorodopamine ((18)F-FDA) PET/computed tomography (CT), (18)F-fluoro-2-deoxy-D-glucose ((18)F-FDG) PET/CT, (123)I-metaiodobenzylguanidine ((123)I-MIBG) scintigraphy, and (111)In-pentetreotide scintigraphy] in the localization of head and neck paragangliomas.
  
  
  RESULTS
  Prospectively (18)F-FDOPA PET localized 26 of 26 lesions in the 10 patients, CT/magnetic resonance imaging localized 21 of 26 lesions, (18)F-FDG PET/CT localized 20 of 26 lesions, (111)In-pentetreotide scintigraphy localized 16 of 25 lesions, (18)F-FDA PET/CT localized 12 of 26 lesions, and (123)I-MIBG scintigraphy localized eight of 26 lesions. Differences in imaging efficacy related to genetic phenotype, even in the present small sample size, included the negativity of (18)F-FDA PET/CT and (123)I-MIBG scintigraphy in patients with SDHB mutations and the accuracy of (18)F-FDG PET/CT in all patients with SDHD mutations, as compared with the accuracy of (18)F-FDG PET/CT in only one patient with an SDHB mutation.
  
  
  CONCLUSIONS
  Overall, (18)F-FDOPA PET proved to be the most efficacious functional imaging modality in the localization of SDHx-related head and neck paragangliomas and may be a potential first-line functional imaging agent for the localization of these tumors.
authors.affiliation: Reproductive and Adult Endocrinology Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, National Institutes of Health, Bethesda, Maryland 20892, USA.
authors.forename: Kathryn S
authors.initials: KS
authors.lastname: King
authors.forename: Clara C
authors.initials: CC
authors.lastname: Chen
authors.forename: Dimitrios K
authors.initials: DK
authors.lastname: Alexopoulos
authors.forename: Millie A
authors.initials: MA
authors.lastname: Whatley
authors.forename: James C
authors.initials: JC
authors.lastname: Reynolds
authors.forename: Nicholas
authors.initials: N
authors.lastname: Patronas
authors.forename: Alexander
authors.initials: A
authors.lastname: Ling
authors.forename: Karen T
authors.initials: KT
authors.lastname: Adams
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Xekouki
authors.forename: Howard
authors.initials: H
authors.lastname: Lando
authors.forename: Constantine A
authors.initials: CA
authors.lastname: Stratakis
authors.forename: Karel
authors.initials: K
authors.lastname: Pacak
mesh_terms: D019797:3-Iodobenzylguanidine; D000328:Adult; D001931:Brain Mapping / Q000379:methods; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives; D004298:Dopamine / Q000031:analogs & derivatives; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010235:Paraganglioma / Q000000981:diagnostic imaging* / Q000235:genetics; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D013004:Somatostatin / Q000031:analogs & derivatives; D013385:Succinate Dehydrogenase / Q000235:genetics*; D014055:Tomography, Emission-Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D019797:3-Iodobenzylguanidine; D013004:Somatostatin; D004295:Dihydroxyphenylalanine; D013385:Succinate Dehydrogenase; C081788:pentetreotide; D004298:Dopamine