title: Compared to123I-MIBG SPECT/CT,18F-DOPA PET/CT provides accurate tumor extent in patients with extra-adrenal paraganglioma.
abstract: OBJECTIVE
  The aim of this study was to compare the accuracy of123I-MIBG SPECT/CT with that of18F-DOPA PET/CT for staging extra-adrenal paragangliomas (PGLs) using both functional and anatomical images (i.e., combined cross-sectional imaging) as the reference standards.
  
  
  METHODS
  Three men and seven women (age range 26-73 years) with anatomical and/or histologically proven disease were included in this study. Three patients had either metastatic head-and-neck paragangliomas (HNPGLs) or multifocal PGL, and seven patients had nonmetastatic disease. Comparative evaluation included morphological imaging with CT, functional imaging with18F-DOPA PET, and123I-MIBG imaging including SPECT/CT. Imaging results were analyzed on a per-patient and per-lesion basis.
  
  
  RESULTS
  On a per-patient basis,18F-DOPA PET's detection rate for both nonmetastatic and metastatic/multifocal disease was 100%, whereas that of planar123I-MIBG imaging alone was 10.0% and that of123I-MIBG SPECT/CT was 20.0%. Overall, on a per-lesion basis,18F-DOPA PET showed a sensitivity of 69.2% (McNemar p < 0.001) compared with anatomical imaging. Sensitivity of planar123I-MIBG scintigraphy was 5.6%, and that of SPECT/CT was 11.1% (McNemar p < 0.0001). Overall,18F-DOPA PET identified 18 lesions, and anatomical imaging identified 26 lesions; planar123IMIBG imaging identified only 1 lesion, and SPECT/CT, 2 lesions.
  
  
  CONCLUSIONS
  18F-DOPA PET is more sensitive than is123I-MIBG imaging, including SPECT/CT, for staging HNPGL. Combined functional and anatomical imaging (PET/CT) is indicated to exclude metastatic disease in extra-adrenal PGL.
authors.affiliation: Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 35 A-6020, Innsbruck, Austria. alexander.kroiss@i-med.ac.at.
authors.forename: Alexander Stephan
authors.initials: AS
authors.lastname: Kroiss
authors.affiliation: Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 35 A-6020, Innsbruck, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Uprimny
authors.affiliation: Department of Nuclear Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Barry Lynn
authors.initials: BL
authors.lastname: Shulkin
authors.affiliation: Department of Vascular Surgery, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Frech
authors.affiliation: Department of Internal Medicine I, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Herbert
authors.initials: H
authors.lastname: Tilg
authors.affiliation: Department of Internal Medicine I, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Rudolf Wolfgang
authors.initials: RW
authors.lastname: Gasser
authors.affiliation: Department of Otorhinolaryngology, State Clinic, St. Poelten, Austria.
authors.forename: Georg Mathias
authors.initials: GM
authors.lastname: Sprinzl
authors.affiliation: Department of Radiology, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Leonhard
authors.initials: L
authors.lastname: Gruber
authors.affiliation: Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Claudius
authors.initials: C
authors.lastname: Thomé
authors.affiliation: Department of Neurosurgery, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Clemens
authors.initials: C
authors.lastname: Plangger
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Url
authors.affiliation: Department of Vascular Surgery, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Gustav
authors.initials: G
authors.lastname: Fraedrich
authors.affiliation: Department of Nuclear Medicine, Medical University Innsbruck, Anichstrasse 35 A-6020, Innsbruck, Austria.
authors.forename: Irene Johanna
authors.initials: IJ
authors.lastname: Virgolini
mesh_terms: D019797:3-Iodobenzylguanidine; D000328:Adult; D000368:Aged; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010236:Paraganglioma, Extra-Adrenal / Q000000981:diagnostic imaging* / Q000473:pathology; D000072078:Positron Emission Tomography Computed Tomography; D012189:Retrospective Studies
chemical_list: C043437:fluorodopa F 18; D019797:3-Iodobenzylguanidine; D004295:Dihydroxyphenylalanine
keywords: 123I-MIBG; 18F-DOPA; Extra-adrenal paraganglioma; PET/CT