68Ga-DOTATATE PET/CT Compared with 131I-MIBG SPECT/CT in the Evaluation of Neural Crest Tumors

Document Type : Original Article

Authors

1 Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran

3 Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Objective(s): 68Ga-DOTATATE positron emission tomography (PET)/computed tomography (CT) has shown promising results in imaging of neural crest tumors (NCT). Herein, we compared the performance of 68Ga-DOTATATE PET/CT and 131I-MIBG single photon emission computed tomography (SPECT)/CT in the initial diagnosis, staging and follow-up of patients with NCTs.
Methods: Twenty-five patients (males:females=8:17; age range=2–71 years) with clinically proven or suspicious neuroblastoma, pheochromocytoma (PCC) or paraganglioma (PGL) were enrolled in this prospective study and underwent both 68Ga-DOTATATE PET/CT and 131I-MIBG SPECT/CT. A composite reference standard derived from histopathological information, together with anatomical and functional imaging findings, was used to validate the results. Imaging findings were assessed on a per-patient and on a per-lesion basis. Sensitivity and accuracy were assessed using McNemar’s test.
Results: Referring to radiological imaging and histopathological findings as reference standard, 68Ga-DOTATATE and 131I-MIBG scans showed a sensitivity and accuracy of (100%, 96%) and (86.7%, 88%), respectively, on a per-patient basis. In PCC/PGL patients, on a per-patient basis, the sensitivity of 68Ga-DOTATATE was 100% and that of 131I-MIBG was 77.8%. In neuroblastoma patients, on a per-patient basis, the sensitivities of both 68Ga-DOTATATE and 131I-MIBG were 100%. Overall, in this patient cohort, 68Ga-DOTATATE PET/CT identified 52 lesions and 131I-MIBG SPECT/CT identified only 30 lesions. On a per-lesion analysis, 68Ga-DOTATATE was found to be superior to 131I-MIBG in detecting lesions in all anatomical locations, particularly osseous lesions. According to the McNemar test results, differences were not statistically significant.
Conclusion: This relatively small patient cohort suggests 68Ga-DOTATATE PET/CT be superior to 131I-MIBG SPECT/CT in providing particularly valuable information for both primary staging and follow-up in patients with NCT. 

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References

1. Bomanji J, Levison DA, Flatman WD, Horne T, Bouloux PM, Ross G, et al. Uptake of iodine-123 MIBG by pheochromocytomas, paragangliomas, and neuroblastomas: a histopathological comparison. Journal of nuclear medicine: official publication, Society of Nuclear Medicine. 1987; 28(6):973-8.
2. Kushner BH. Neuroblastoma: a disease requiring a multitude of imaging studies. Journal of Nuclear Medicine. 2004; 45(7):1172-88.
3. Pfluger T, Schmied C, Porn U, Leinsinger G, Vollmar C, Dresel S, et al. Integrated Imaging Using MRI and 123| Metaiodobenzylguanidine Scintigraphy to Improve Sensitivity and Specificity in the Diagnosis of Pediatric Neuroblastoma. American Journal of Roentgenology. 2003; 181(4):1115-24.
4.Briganti V, Sestini R, Orlando C, Bernini G, La Cava G, Tamburini A, et al. Imaging of somatostatin receptors by indium-111-pentetreotide correlates with quantitative determination of somatostatin receptor type 2 gene expression in neuroblastoma tumors. Clinical Cancer Research. 1997; 3(12):2385-91.
5. Piccardo A, Lopci E, Conte M, Garaventa A, Foppiani L, Altrinetti V, et al. Comparison of 18 F-dopa PET/CT and 123 I-MIBG scintigraphy in stage 3 and 4 neuroblastoma: a pilot study. European journal of nuclear medicine and molecular imaging. 2012; 39(1):57-71.
6. Papathanasiou ND, Gaze MN, Sullivan K, Aldridge M, Waddington W, Almuhaideb A, et al. 18F-FDG PET/CT and 123I-metaiodobenzylguanidine imaging in high-risk neuroblastoma: diagnostic comparison and survival analysis. Journal of Nuclear Medicine. 2011; 52(4):519-25.
7. Hoefnagel CA. Metaiodobenzylguanidine and somatostatin in oncology: role in the management of neural crest tumours. European journal of nuclear medicine. 1994; 21(6):561-81.
8. Rozovsky K, Koplewitz BZ, Krausz Y, Revel-Vilk S, Weintraub M, Chisin R, et al. Added value of SPECT/CT for correlation of MIBG scintigraphy and diagnostic CT in neuroblastoma and pheochromocytoma. AJR American journal of roentgenology. 2008; 190(4):1085-90.
9. Bomanji J, Levison D, Flatman W, Horne T, Bouloux P-G, Ross G, et al. Uptake of iodine-123 MIBG by pheochromocytomas, paragangliomas, and neuroblastomas: a histopathological comparison. Journal of nuclear medicine. 1987; 28(6):973-8.
10. Sisson J, Shulkin B. Nuclear medicine imaging of pheochromocytoma and neuroblastoma. The Quarterly Journal of Nuclear Medicine and Molecular Imaging. 1999; 43(3):217.
11. Antunes P, Ginj M, Zhang H, Waser B, Baum R, Reubi J-C, et al. Are radiogallium-labelled DOTA-conjugated somatostatin analogues superior to those labelled with other radiometals? European journal of nuclear medicine and molecular imaging. 2007; 34(7):982-93.
12. Walker RC, Smith GT, Liu E, Moore B, Clanton J, Stabin M. Measured human dosimetry of 68Ga-DOTATATE. Journal of Nuclear Medicine. 2013; 54(6):855-60.
13. Hofman MS, Kong G, Neels OC, Eu P, Hong E, Hicks RJ. High management impact of Ga‐68 DOTATATE (GaTate) PET/CT for imaging neuroendocrine and other somatostatin expressing tumours. Journal of medical imaging and radiation oncology. 2012; 56(1):40-7.
14. Timmers HJ, Chen CC, Carrasquillo JA, Whatley M, Ling A, Havekes B, et al. Comparison of 18F-fluoro-L-DOPA, 18F-fluoro-deoxyglucose, and 18F-fluorodopamine PET and 123I-MIBG scintigraphy in the localization of pheochromocytoma and paraganglioma. The Journal of Clinical Endocrinology & Metabolism. 2009; 94(12):4757-67.
15. Tan TH, Hussein Z, Saad FFA, Shuaib IL. Diagnostic performance of 68 Ga-DOTATATE PET/CT,18F-FDG PET/CT and 131 I-MIBG scintigraphy in mapping metastatic pheochromocytoma and paraganglioma. Nuclear medicine and molecular imaging. 2015; 49(2):143-51.
16. Havekes B, King K, Lai EW, Romijn JA, Corssmit EP, Pacak K. New imaging approaches to phaeochromocytomas and paragangliomas. Clinical endocrinology. 2010; 72(2):137-45.
17. Rozovsky K, Koplewitz BZ, Krausz Y, Revel-Vilk S, Weintraub M, Chisin R, et al. Added value of SPECT/CT for correlation of MIBG scintigraphy and diagnostic CT in neuroblastoma and pheochromocytoma. American Journal of Roentgenology. 2008; 190(4):1085-90.
18. Bhatia KS, Ismail MM, Sahdev A, Rockall AG, Hogarth K, Canizales A, et al. 123I‐metaiodobenzylguanidine (MIBG) scintigraphy for the detection of adrenal and extra‐adrenal phaeochromocytomas: CT and MRI correlation. Clinical endocrinology. 2008; 69(2):181-8.
19. Win Z, Al-Nahhas A, Towey D, Todd JF, Rubello D, Lewington V, et al. 68Ga-DOTATATE PET in neuroectodermal tumours: first experience. Nuclear medicine communications. 2007; 28(5):359-63.
20. Naji M, Zhao C, Welsh SJ, Meades R, Win Z, Ferrarese A, et al. 68 Ga-DOTA-TATE PET vs. 123 I-MIBG in identifying malignant neural crest tumours. Molecular Imaging and Biology. 2011; 13(4):769-75.
21. Maurice J, Troke R, Win Z, Ramachandran R, Al-Nahhas A, Naji M, et al. A comparison of the performance of 68 Ga-DOTATATE PET/CT and 123 I -MIBG SPECT in the diagnosis and follow-up of phaeochromocytoma and paraganglioma. European journal of nuclear medicine and molecular imaging. 2012; 39(8):1266-70.
22. Jing H, Li F, Wang L, Wang Z, Li W, Huo L, et al. Comparison of the 68Ga-DOTATATA PET/CT, FDG PET/CT, and MIBG SPECT/CT in the evaluation of suspected primary pheochromocytomas and paragangliomas. Clinical nuclear medicine. 2017; 42(7):525-9.
23. Watanabe H, Okada M, Kaji Y, Satouchi M, Sato Y, Yamabe Y, et al. New response evaluation criteria in solid tumours-revised RECIST guideline (version 1.1). Gan to kagaku ryoho Cancer & chemotherapy. 2009; 36(13):2495.
24. Kroiss A, Putzer D, Uprimny C, Decristoforo C, Gabriel M, Santner W, et al. Functional imaging in phaeochromocytoma and neuroblastoma with 68 Ga-DOTA-Tyr 3-octreotide positron emission tomography and 123 I-metaiodobenzylguanidine. European journal of nuclear medicine and molecular imaging. 2011; 38(5):865-73.
25. Sharma P, Dhull VS, Arora S, Gupta P, Kumar R, Durgapal P, et al. Diagnostic accuracy of 68 Ga-DOTANOC PET/CT imaging in pheochromocytoma. European journal of nuclear medicine and molecular imaging. 2014; 41(3):494-504.
26. Cantalamessa A, Caobelli F, Paghera B, Caobelli A, Vavassori F. Role of 18 F-FDG PET/CT, 123 I-MIBG SPECT, and CT in restaging patients affected by malignant pheochromocytoma. Nuclear medicine and molecular imaging. 2011; 45(2):125-31.
Asia Oceania Journal of Nuclear Medicine and Biology
Volume 8, Issue 1
January 2020
Pages 8-17

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