title: (68)Ga-DOTATOC PET/CT provides accurate tumour extent in patients with extraadrenal paraganglioma compared to (123)I-MIBG SPECT/CT.
abstract: OBJECTIVE
  The aim of this study was to compare the accuracy of (123)I-MIBG SPECT/CT with that of (68)Ga-DOTATOC PET/CT for staging extraadrenal paragangliomas (PGL) using both functional and anatomical images (i.e. combined cross-sectional imaging) as the reference standards.
  
  
  METHODS
  The study included three men and seven women (age range 26 to 73 years) with anatomical and/or histologically proven disease. Three patients had either metastatic head and neck PGL (HNPGL) or multifocal extraadrenal PGL, and seven patients had nonmetastatic extraadrenal disease. Comparative evaluation included morphological imaging with CT, functional imaging with (68)Ga-DOTATOC PET, and (123)I-MIBG imaging. The imaging results were analysed on a per-patient and on a per-lesion basis.
  
  
  RESULTS
  On a per-patient basis, the detection rate of (68)Ga-DOTATOC PET was 100 %, whereas that of planar (123)I-MIBG imaging was 10.0 % and with SPECT/CT 20.0 % for both nonmetastatic and metastatic/multifocal extraadrenal PGL. On a per-lesion basis, the overall sensitivity of (68)Ga-DOTATOC PET was 100 % (McNemar p < 0.5), that of planar (123)I-MIBG imaging was 3.4 % (McNemar p < 0.001) and that of SPECT/CT was 6.9 % (McNemar p < 0.001). Both (68)Ga-DOTATOC PET and anatomical imaging identified 27 lesions. Planar (123)I-MIBG imaging identified only one lesion, and SPECT/CT two lesions. Two additional lesions were detected by (68)Ga-DOTATOC PET but not by either (123)I-MIBG or CT imaging.
  
  
  CONCLUSIONS
  Our analysis in this patient cohort indicated that (68)Ga-DOTATOC PET/CT is superior to (123)I-MIBG SPECT/CT, particularly in head and neck and bone lesions, and provides valuable information for staging extraadrenal PGL, particularly in patients with surgically inoperable tumours or multifocal/malignant disease.
authors.affiliation: Department of Nuclear Medicine, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria, alexander.kroiss@i-med.ac.at.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kroiss
authors.forename: Barry Lynn
authors.initials: BL
authors.lastname: Shulkin
authors.forename: Christian
authors.initials: C
authors.lastname: Uprimny
authors.forename: Andreas
authors.initials: A
authors.lastname: Frech
authors.forename: Rudolf Wolfgang
authors.initials: RW
authors.lastname: Gasser
authors.forename: Christoph
authors.initials: C
authors.lastname: Url
authors.forename: Kurt
authors.initials: K
authors.lastname: Gautsch
authors.forename: Ruth
authors.initials: R
authors.lastname: Madleitner
authors.forename: Bernhard
authors.initials: B
authors.lastname: Nilica
authors.forename: Georg Mathias
authors.initials: GM
authors.lastname: Sprinzl
authors.forename: Guenther
authors.initials: G
authors.lastname: Gastl
authors.forename: Gustav
authors.initials: G
authors.lastname: Fraedrich
authors.forename: Irene Johanna
authors.initials: IJ
authors.lastname: Virgolini
mesh_terms: D019797:3-Iodobenzylguanidine; D000328:Adult; D000368:Aged; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000592:standards; D015282:Octreotide / Q000031:analogs & derivatives*; D009942:Organometallic Compounds; D010236:Paraganglioma, Extra-Adrenal / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000592:standards*; D019275:Radiopharmaceuticals; D012015:Reference Standards; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon / Q000592:standards*; D014057:Tomography, X-Ray Computed / Q000592:standards
chemical_list: C499142:Ga(III)-DOTATOC; D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine; D015282:Octreotide