Prospective evaluation of 68Ga-DOTA-NOC PET-CT in phaeochromocytoma and paraganglioma: preliminary results from a single centre study

To evaluate the role of Ga-68-labelled [1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid]-1-NaI3-Octreotide (Ga-68-DOTA-NOC) whole body positron emission tomography-computed tomography (PET-CT) as a functional imaging approach for phaeochromocytoma and paraganglioma. Thirty-five unrelated patients (Median age-34.4 years; range: 15-71) were evaluated in this prospective study. PET-CT was performed after injection of 132-222 MBq of Ga-68-DOTA-NOC. Images were evaluated by two experienced nuclear medicine physicians both qualitatively as well as quantitatively (standardised uptake value-SUVmax). In addition we compared the findings with I-131 Metaiodobenzylguanidine (MIBG) scintigraphy, which was available for 25 patients. Histopathology and/or conventional imaging with biochemical markers were taken as the reference standard. 44 lesions were detected on Ga-68-DOTA-NOC PET-CT imaging with an additional detection of 12 lesions not previously known, leading to a change in management of 6 patients. Sensitivity, specificity and accuracy were 100%, 85.7%, and 97.1% on a per patient basis and 100%, 85.7% and 98% on per lesion basis, respectively.I-131 MIBG scintigraphy was concordant with Ga-68-DOTA-NOC PET-CT in 16 patients and false negative in 9 patients. Ga-68-DOTA-NOC PET-CT is highly sensitive and specific for the detection of phaeochromoctyomas and paragangliomas. It seems better than I-131 MIBG scintigraphy for this purpose. aEuro cent (68) Ga-DOTA-NOC PET-CT seems useful in patients with phaeochromocytoma and paraganglioma. aEuro cent This prospective single centre study showed that it has high diagnostic accuracy. aEuro cent (68) Ga-DOTA-NOC PET-CT seems superior to (131) I-MIBG in these patients.