NANETS2022 15th Annual Multidisciplinary NET Medical Symposium NANETS 2022 Clinical – Nuclear Medicine/Interventional Radiology/Imaging (16 abstracts)
Performance of 68Ga-DOTATATE PET/CT, 18F-FDG PET/CT, CT, and MRI Spine in the Detection of Spinal Bone Metastases in Metastatic Pheochromocytoma/Paraganglioma
Abhishek Jha 1 , Mayank Patel 1 , Babak Saboury 2 , Corina Millo 3 , Alexander Ling 4 , Ritu Shah 4 , Clara C. Chen 2 , Leah Meuter 1 , Sara Talvacchio 1 , Marianne Knue 1 , Frank I. Lin 5 , Geraldine O’Sullivan Coyne 6 , Alice P. Chen 6 , Naris Nilubol 7 , Peter Herscovitch 3 , David Taïeb 8 , Ali Cahid Civelek 9 , Jorge A. Carrasquillo 10 & Karel Pacak 1
1Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 10 Center Dr., Bldg. 10, Room 1E-3140, Bethesda, MD, 20892, USA; 2Nuclear Medicine Division, Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Dr., Bldg. 10, Bethesda, MD, 20892, USA; 3Positron Emission Tomography Department, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Dr., Bldg. 10, Bethesda, MD, 20892, USA; 4Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, 10 Center Dr., Bldg. 10, Bethesda, MD, 20892, USA; 5Molecular Imaging Program, National Cancer Institute, National Institutes of Health, 10 Center Dr., Bldg. 10, Bethesda, MD, 20892, USA; 6Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA; 7Surgical Oncology Program, Center for Cancer Research, National Cancer Institute, 10 Center Dr., Bldg. 10, Room 4-5952, Bethesda, MD, 20892, USA; 8Department of Nuclear Medicine, La Timone University Hospital, CERIMED, Aix-Marseille University, Marseille, France; 9Nuclear Medicine, Radiology and Radiological Science, Johns Hopkins Medicine, Baltimore, MD, USA; 10Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, MD, 10065, USA.
Background: To evaluate and compare the diagnostic performance of 68Ga-DOTATATE PET/CT to 18F-FDG PET/CT, CT of neck, chest, abdomen and pelvis (CT), and MRI of cervical, thoracic, and lumbar spine (MRI spine), for the detection of spinal bone metastases in metastatic pheochromocytoma and/or paraganglioma (PPGL).
Methods: Between 2014 and 2019, 41 consecutive metastatic PPGL patients (19 females; mean age, 43 years) underwent 68Ga-DOTATATE PET/CT, 18F-FDG PET/CT, and MRI (sagittal T1w, sagittal STIR, axial T1w, and axial T2w) for evaluation of spinal bone metastases. Thirty patients also underwent CT (iv and oral contrast). The mean (±standard deviation) duration between 68Ga-DOTATATE PET/CT and 18F-FDG PET/CT was 21±46 days, between 68Ga-DOTATATE PET/CT and CT 18±40 days, and between 68Ga-DOTATATE PET/CT and MRI spine 27±40 days. Per patient and per lesion detection rates of 68Ga-DOTATATE PET/CT, 118F-FDG PET/CT, CT, and MRI spine was calculated. Counting of spinal bone metastases was limited to a maximum of one lesion per vertebrae. A composite of all the scans served as an imaging comparator. McNemar test was used to compare detection rates between the scans. Two-sided p values <0.05 were considered statistically significant.
Results: All patients were positive for spinal bone metastases, with 484 lesions on the imaging comparator. 68Ga-DOTATATE PET/CT demonstrated a per lesion detection rate of 401/484 [82.9%, 95% confidence interval (CI): 79.2-86.1%]. 18F-FDG PET/CT, MRI spine, and CT showed significantly lower per lesion detection rates of 262/484 (54.1%, 95% CI: 49.6-58.6%; P<0.0001), 350/484 (72.3%, 95% CI: 68.1-76.3%; P=0.001), and 117/327 (35.8%, 95% CI: 30.6-41.2%; P<0.0001), respectively. The per patient detection rates of 68Ga-DOTATATE PET/CT was 41/41 (100%, 95% CI: 91.4-100%), and that of 18F-FDG PET/CT, MRI spine, and CT was 36/41 (87.8%, 73.8-95.9%), 39/41 (95.1%, 83.5-99.4%), and 25/30 (83.3%, 65.3-94.3%), respectively. Further, 68Ga-DOTATATE PET/CT was found to detect greater or equal lesions compared to 18F-FDG PET/CT, MRI spine, and CT in 38/41 (92.7%), 30/41 (73.2%), and 27/30 (90.0%) patients, respectively.
Conclusions: 68Ga-DOTATATE PET/CT showed a significantly superior detection rate of spinal bone metastases compared to 18F-FDG PET/CT, CT, and MRI spine. Besides providing a whole-body analysis, it maybe the modality of choice to evaluate metastatic spine disease especially in the treatment planning and response assessment of the targeted radionuclide therapy (223Ra, 177Lu/90Y, 131I).
Abstract ID 21579
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more