title: Head-to-head comparison between18F-FDOPA PET/CT and MR/CT angiography in clinically recurrent head and neck paragangliomas.
abstract: OBJECTIVE
  Head and neck paragangliomas (HNPGLs) can relapse after primary treatment. Optimal imaging protocols have not yet been established for posttreatment evaluation. The aim of the present study was to assess the diagnostic value of18F-FDOPA PET/CT and MR/CT angiography (MRA/CTA) in HNPGL patients with clinical relapse during their follow-up.
  
  
  METHODS
  Sixteen consecutive patients presenting with local pain, tinnitus, dysphagia, hoarse voice, cranial nerve involvement, deafness, or retrotympanic mass appearing during follow-up after the initial treatment of HNPGLs were retrospectively evaluated. Patients underwent both18F-FDOPA PET/CT and MRA (15 patents) or CTA (1 patent). Both methods were first assessed under blinded conditions and afterwards correlated. Head and neck imaging abnormalities without histological confirmation were considered true-positive results based on a consensus between radiologists and nuclear physicians and on further18F-FDOPA PET/CT and/or MRA.
  
  
  RESULTS
  18F-FDOPA PET/CT and MRA/CTA were concordant in 14 patients and in disagreement in 2 patients.18F-FDOPA PET/CT and MRA/CTA identified, respectively, 12 and 10 presumed recurrent HNPGLs in 12 patients. The two lesions diagnosed by PET/CT only were confirmed during follow-up by otoscopic examination and MRA performed 29 and 17 months later.18F-FDOPA PET/CT images were only slightly influenced by the posttreatment sequelae, showing a better interobserver reproducibility than MRA/CTA. Finally, in 2 of the 16 studied patients,18F-FDOPA PET/CT detected two additional synchronous primary HNPGLs.
  
  
  CONCLUSIONS
  18F-FDOPA PET/CT is highly sensitive in posttreatment evaluation of patients with HNPGLs, and also offers better interobserver reproducibility than MRA/CTA and whole-body examination. We therefore suggest that18F-FDOPA PET/CT is performed as the first diagnostic imaging modality in symptomatic patients with suspicion of HNPGL relapse after primary treatment when68Ga-labeled somatostatin analogues are not available.
authors.affiliation: Department of Biophysics and Nuclear Medicine, University Hospitals of Strasbourg, Strasbourg, France.|ICube, UMR 7357, CNRS/University of Strasbourg, Strasbourg, France.|FMTS, Faculty of Medicine, University of Strasbourg, Strasbourg, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Heimburger
authors.affiliation: Department of Radiology, University Hospitals of Strasbourg, Strasbourg, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Veillon
authors.affiliation: Department of Nuclear Medicine, La Timone University Hospital, Aix-Marseille University, Marseille, France.|European Center for Research in Medical Imaging, Aix-Marseille University, Marseille, France.|Inserm UMR1068 Marseille Cancerology Research Center, Institut Paoli-Calmettes, Marseille, France.
authors.forename: David
authors.initials: D
authors.lastname: Taïeb
authors.affiliation: Department of Internal Medicine, University Hospitals of Strasbourg, Strasbourg, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Goichot
authors.affiliation: Department of Radiology, University Hospitals of Strasbourg, Strasbourg, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Riehm
authors.affiliation: Department of Otolaryngology and Maxillofacial Surgery, University Hospitals of Strasbourg, Strasbourg, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Petit-Thomas
authors.affiliation: Department of Pathology, University Hospitals of Strasbourg, Strasbourg, France.
authors.forename: Gerlinde
authors.initials: G
authors.lastname: Averous
authors.affiliation: Department of Radiology, University Hospitals of Strasbourg, Strasbourg, France.
authors.forename: Marcela
authors.initials: M
authors.lastname: Cavalcanti
authors.affiliation: Department of Biophysics and Nuclear Medicine, University Hospitals of Strasbourg, Strasbourg, France.|ICube, UMR 7357, CNRS/University of Strasbourg, Strasbourg, France.|FMTS, Faculty of Medicine, University of Strasbourg, Strasbourg, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Hubelé
authors.affiliation: Department of Internal Medicine, University Hospitals of Strasbourg, Strasbourg, France.
authors.forename: Gerard
authors.initials: G
authors.lastname: Chabrier
authors.affiliation: Department of Biophysics and Nuclear Medicine, University Hospitals of Strasbourg, Strasbourg, France.|ICube, UMR 7357, CNRS/University of Strasbourg, Strasbourg, France.|FMTS, Faculty of Medicine, University of Strasbourg, Strasbourg, France.
authors.forename: Izzie Jacques
authors.initials: IJ
authors.lastname: Namer
authors.affiliation: Department of Otolaryngology and Maxillofacial Surgery, University Hospitals of Strasbourg, Strasbourg, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Charpiot
authors.affiliation: Department of Biophysics and Nuclear Medicine, University Hospitals of Strasbourg, Strasbourg, France. alessio.imperiale@chru-strasbourg.fr.|ICube, UMR 7357, CNRS/University of Strasbourg, Strasbourg, France. alessio.imperiale@chru-strasbourg.fr.|FMTS, Faculty of Medicine, University of Strasbourg, Strasbourg, France. alessio.imperiale@chru-strasbourg.fr.|Biophysics and Nuclear Medicine, Hautepierre University Hospital, 1, Avenue Molière, 67098, Strasbourg Cedex, France. alessio.imperiale@chru-strasbourg.fr.
authors.forename: Alessio
authors.initials: A
authors.lastname: Imperiale
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001692:Biological Transport; D000072226:Computed Tomography Angiography; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives* / Q000378:metabolism; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010235:Paraganglioma / Q000000981:diagnostic imaging* / Q000378:metabolism; D000072078:Positron Emission Tomography Computed Tomography; D012008:Recurrence; D012189:Retrospective Studies
chemical_list: C043437:fluorodopa F 18; D004295:Dihydroxyphenylalanine
keywords: 18F-FDOPA; Head and neck; Magnetic resonance angiography; Paraganglioma; Positron emission tomography; Recurrence