68Ga DOTATATE PET/CT in the Localization of Head and Neck Paragangliomas Compared with Other Functional Imaging Modalities and CT/MRI
Pheochromocytomas/paragangliomas overexpress somatostatin receptors, and recent studies have already shown excellent results in the localization of sympathetic succinate dehydrogenase complex, subunit B, mutation related metastatic pheochromocytomas/paragangliomas using 68Ga DOTATATE PET/CT. Therefore, the goal of our study was to assess the clinical utility of this functional imaging modality in parasympathetic head and neck paragangliomas (HNPGLs) compared with anatomic imaging with CT/MRI and other functional imaging modalities, including 18F fluorohydroyphenylalanine (18F FDOPA) PET/CT, currently the gold standard in the functional imaging of HNPGLs. Methods: 68Ga DOTATATE PET/CT was prospectively performed in 20 patients with HNPGLs. All patients also underwent 18F FDOPA PET/CT, 18F FDG PET/CT, and CT/MRI, with 18 patients also undergoing 18F fluorodopamine (18F FDA) PET/CT. 18F FDOPA PET/CT and CT/MRI served as the imaging comparators. Results: Thirty eight lesions in 20 patients were detected, with 18F FDOPA PET/CT identifying 37 of 38 and CT/MRI identifying 23 of 38 lesions (P 0.01) All 38 and an additional 7 lesions (P 0.016) were detected on 68Ga DOTATATE PET/CT. Significantly fewer lesions were identified by 18F FDG PET/CT (24/38, P 0.01) and 18F FDA PET/CT (10/34, P 0.01) Conclusion: 68Ga DOTATATE PET/CT identified more lesions than other imaging modalities. With the results of the present study, and the increasing availability and use of DOTA analogs in the therapy of neuroendocrine tumors, we expect that 68Ga DOTATATE PET/CT will become the preferred functional imaging modality for HNPGLs in the near future.
The Journal of Nuclear Medicine