68Ga-DOTA-TATE PET vs. 123I-MIBG in Identifying Malignant Neural Crest Tumours
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- Naji, M., Zhao, C., Welsh, S.J. et al. Mol Imaging Biol (2011) 13: 769. doi:10.1007/s11307-010-0396-8
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We aimed to compare imaging with 123I-MIBG and 68Ga-DOTA-TATE in neural crest tumours (NCT) to see if the latter could offer more advantage in detecting extra lesions and have higher sensitivity for malignant lesions.
We retrospectively reviewed 12 patients (M = 10, F = 2; age range 20–71 years) with NCT (phaeochromocytomas = 7, paragangliomas = 4, medullary thyroid cancer = 1) who underwent both 68Ga-DOTA-TATE positron emission tomography (PET) or PET/computed tomography (CT) and 123I-MIBG single-photon emission computed tomography within 6 months. Visual assessment of all lesions and measurement of target/non-target (T/N) ratio in selected lesions were performed. Five patients (aged 50 or less) had SDHB screening results correlated with imaging results of both radiopharmaceuticals. All patients had contrast-enhanced CT and/or other cross-sectional imaging.
68Ga-DOTA-TATE PET showed tumour lesions in ten out of 12 patients with confirmed disease, while 123I-MIBG showed lesions in five out of 12 patients. In one patient, both 68Ga-DOTA-TATE PET and 123I-MIBG were negative, but CT, magnetic resonance imaging, and 2-deoxy-2-[18F]fluoro-D-glucose PET scans identified a lesion in the thorax. 68Ga-DOTA-TATE and 123I-MIBG detected a total of 30 lesions, of which 29/30 were positive with 68Ga-DOTA-TATE and 7/30 with 123I-MIBG. We also found higher incidence of SDHB positive results in patients with positive 68Ga-DOTA-TATE.
Our limited data suggest that 68Ga-DOTA-TATE is a better imaging agent for NCT and detects significantly more lesions with higher T/N ratio compared to 123I-MIBG. 68Ga-DOTA-TATE was more likely to detect malignant lesions as indicated by correlating imaging results with SDHB screening.