title: Diagnostic accuracy of (68)Ga-DOTANOC PET/CT imaging in pheochromocytoma.
abstract: OBJECTIVE
  The purpose of the present study was to evaluate the diagnostic accuracy of (68)Ga-DOTANOC positron emission tomography (PET)/CT in patients with suspicion of pheochromocytoma.
  
  
  METHODS
  Data of 62 patients [age 34.3 ± 16.1 years, 14 with multiple endocrine neoplasia type 2 (MEN2)] with clinical/biochemical suspicion of pheochromocytoma and suspicious adrenal lesion on contrast CT (n = 70), who had undergone (68)Ga-DOTANOC PET/CT, were retrospectively analyzed. PET/CT images were analyzed visually as well as semiquantitatively, with measurement of maximum standardized uptake value (SUVmax), SUVmean, SUVmax/SUVliver, and SUVmean/SUVliver. Results of PET/CT were compared with (131)I-metaiodobenzylguanidine (MIBG) imaging, which was available in 40 patients (45 lesions). Histopathology and/or imaging/clinical/biochemical follow-up (minimum 6 months) was used as reference standard.
  
  
  RESULTS
  The sensitivity, specificity, and accuracy of (68)Ga-DOTANOC PET/CT was 90.4, 85, and 88.7%, respectively, on patient-based analysis and 92, 85, and 90%, respectively, on lesion-based analysis. (68)Ga-DOTANOC PET/CT showed 100% accuracy in patients with MEN2 syndrome and malignant pheochromocytoma. On direct comparison, lesion-based accuracy of (68)Ga-DOTANOC PET/CT for pheochromocytoma was significantly higher than (131)I-MIBG imaging (91.1 vs 66.6%, p = 0.035). SUVmax was higher for pheochromocytomas than other adrenal lesions (p = 0.005), MEN2-associated vs sporadic pheochromocytoma (p = 0.012), but no difference was seen between benign vs malignant pheochromocytoma (p = 0.269).
  
  
  CONCLUSIONS
  (68)Ga-DOTANOC PET/CT shows high diagnostic accuracy in patients with suspicion of pheochromocytoma and is superior to (131)I-MIBG imaging for this purpose. Best results of (68)Ga-DOTANOC PET/CT are seen in patients with MEN2-associated and malignant pheochromocytoma.
authors.affiliation: Department of Nuclear Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
authors.forename: Punit
authors.initials: P
authors.lastname: Sharma
authors.forename: Varun Singh
authors.initials: VS
authors.lastname: Dhull
authors.forename: Saurabh
authors.initials: S
authors.lastname: Arora
authors.forename: Poonam
authors.initials: P
authors.lastname: Gupta
authors.forename: Rajeev
authors.initials: R
authors.lastname: Kumar
authors.forename: Prashant
authors.initials: P
authors.lastname: Durgapal
authors.forename: Arun
authors.initials: A
authors.lastname: Malhotra
authors.forename: Sunil
authors.initials: S
authors.lastname: Chumber
authors.forename: Ariachery C
authors.initials: AC
authors.lastname: Ammini
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kumar
authors.forename: Chandrasekhar
authors.initials: C
authors.lastname: Bal
mesh_terms: D019797:3-Iodobenzylguanidine / Q000592:standards; D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging*; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009942:Organometallic Compounds / Q000592:standards; D010673:Pheochromocytoma / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals / Q000592:standards; D012015:Reference Standards; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
chemical_list: C504894:68Ga-DOTANOC; D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine