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6-[F-18]Fluoro-L-dihydroxyphenylalanine positron emission tomography is superior to conventional imaging with (123)I-metaiodobenzylguanidine scintigraphy, computer tomography, and magnetic resonance imaging in localizing tumors causing catecholamine excess.
- Source :
-
The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2009 Oct; Vol. 94 (10), pp. 3922-30. Date of Electronic Publication: 2009 Jul 21. - Publication Year :
- 2009
-
Abstract
- Context: Catecholamine excess is rare, but symptoms may be life threatening.<br />Objective: The objective of the study was to investigate the sensitivity of 6-[F-18]fluoro-l-dihydroxyphenylalanine positron emission tomography ((18)F-DOPA PET), compared with (123)I-metaiodobenzylguanidine ((123)I-MIBG) scintigraphy and computer tomography (CT)/magnetic resonance imaging (MRI) for tumor localization in patients with catecholamine excess.<br />Design and Setting: All consecutive patients with catecholamine excess visiting the University Medical Center Groningen, Groningen, The Netherlands, between March 2003 and January 2008 were eligible.<br />Patients: Forty-eight patients were included. The final diagnosis was pheochromocytoma in 40, adrenal hyperplasia in two, paraganglioma in two, ganglioneuroma in one, and unknown in three.<br />Main Outcome Measures: Sensitivities and discordancy between (18)F-DOPA PET, (123)I-MIBG, and CT or MRI were analyzed for individual patients and lesions. Metanephrines and 3-methoxytyramine in plasma and urine and uptake of (18)F-DOPA with PET were measured to determine the whole-body metabolic burden and correlated with biochemical tumor activity. The gold standard was a composite reference standard.<br />Results: (18)F-DOPA PET showed lesions in 43 patients, (123)I-MIBG in 31, and CT/MRI in 32. Patient-based sensitivity for (18)F-DOPA PET, (123)I-MIBG, and CT/MRI was 90, 65, and 67% (P < 0.01 for (18)F-DOPA PET vs. both (123)I-MIBG and CT/MRI, P = 1.0 (123)I-MIBG vs. CT/MRI). Lesion-based sensitivities were 73, 48, and 44% (P < 0.001 for (18)F-DOPA PET vs. both (123)I-MIBG and CT/MRI, P = 0.51 (123)I-MIBG vs. CT/MRI). The combination of (18)F-DOPA PET with CT/MRI was superior to (123)I-MIBG with CT/MRI (93 vs. 76%, P < 0.001). Whole-body metabolic burden measured with (18)F-DOPA PET correlated with plasma normetanephrine (r = 0.82), urinary normetanephrine (r = 0.84), and metanephrine (r = 0.57).<br />Conclusion: To localize tumors causing catecholamine excess, (18)F-DOPA PET is superior to (123)I-MIBG scintigraphy and CT/MRI.
- Subjects :
- 3-Iodobenzylguanidine
Adolescent
Adrenal Gland Neoplasms diagnostic imaging
Adrenal Gland Neoplasms metabolism
Adrenal Glands metabolism
Adult
Aged
Biomarkers metabolism
Catecholamines blood
Catecholamines urine
Child
Child, Preschool
Dihydroxyphenylalanine analogs & derivatives
Female
Humans
Hyperplasia diagnosis
Male
Middle Aged
Paraganglioma diagnostic imaging
Paraganglioma metabolism
Pheochromocytoma diagnostic imaging
Pheochromocytoma metabolism
Prospective Studies
Radiopharmaceuticals
Sensitivity and Specificity
Young Adult
Adrenal Gland Neoplasms diagnosis
Adrenal Glands pathology
Catecholamines metabolism
Magnetic Resonance Imaging
Paraganglioma diagnosis
Pheochromocytoma diagnosis
Positron-Emission Tomography methods
Tomography, X-Ray Computed
Subjects
Details
- Language :
- English
- ISSN :
- 1945-7197
- Volume :
- 94
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- The Journal of clinical endocrinology and metabolism
- Publication Type :
- Academic Journal
- Accession number :
- 19622618
- Full Text :
- https://doi.org/10.1210/jc.2009-1054