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Diagnostic accuracy of 68Ga-DOTANOC PET/CT imaging in pheochromocytoma

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The purpose of the present study was to evaluate the diagnostic accuracy of 68Ga-DOTANOC positron emission tomography (PET)/CT in patients with suspicion of pheochromocytoma.

Methods

Data of 62 patients [age 34.3 ± 16.1 years, 14 with multiple endocrine neoplasia type 2 (MEN2)] with clinical/biochemical suspicion of pheochromocytoma and suspicious adrenal lesion on contrast CT (n = 70), who had undergone 68Ga-DOTANOC PET/CT, were retrospectively analyzed. PET/CT images were analyzed visually as well as semiquantitatively, with measurement of maximum standardized uptake value (SUVmax), SUVmean, SUVmax/SUVliver, and SUVmean/SUVliver. Results of PET/CT were compared with 131I-metaiodobenzylguanidine (MIBG) imaging, which was available in 40 patients (45 lesions). Histopathology and/or imaging/clinical/biochemical follow-up (minimum 6 months) was used as reference standard.

Results

The sensitivity, specificity, and accuracy of 68Ga-DOTANOC PET/CT was 90.4, 85, and 88.7 %, respectively, on patient-based analysis and 92, 85, and 90 %, respectively, on lesion-based analysis. 68Ga-DOTANOC PET/CT showed 100 % accuracy in patients with MEN2 syndrome and malignant pheochromocytoma. On direct comparison, lesion-based accuracy of 68Ga-DOTANOC PET/CT for pheochromocytoma was significantly higher than 131I-MIBG imaging (91.1 vs 66.6 %, p = 0.035). SUVmax was higher for pheochromocytomas than other adrenal lesions (p = 0.005), MEN2-associated vs sporadic pheochromocytoma (p = 0.012), but no difference was seen between benign vs malignant pheochromocytoma (p = 0.269).

Conclusion

68Ga-DOTANOC PET/CT shows high diagnostic accuracy in patients with suspicion of pheochromocytoma and is superior to 131I-MIBG imaging for this purpose. Best results of 68Ga-DOTANOC PET/CT are seen in patients with MEN2-associated and malignant pheochromocytoma.

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Authors and Affiliations

  1. Department of Nuclear Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India

    Punit Sharma, Varun Singh Dhull, Saurabh Arora, Rajeev Kumar, Arun Malhotra, Rakesh Kumar & Chandrasekhar Bal

  2. Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India

    Poonam Gupta & Ariachery C. Ammini

  3. Department of Pathology, All India Institute of Medical Sciences, New Delhi, India

    Prashant Durgapal

  4. Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India

    Sunil Chumber

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  1. Punit Sharma
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Correspondence to Chandrasekhar Bal.

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Sharma, P., Dhull, V.S., Arora, S. et al. Diagnostic accuracy of 68Ga-DOTANOC PET/CT imaging in pheochromocytoma. Eur J Nucl Med Mol Imaging 41, 494–504 (2014). https://doi.org/10.1007/s00259-013-2598-1

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  • DOI: https://doi.org/10.1007/s00259-013-2598-1

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