[^18F]mFBG PET/CT imaging outperforms MRI and [^68 Ga]Ga-DOTA-TOC PET/CT in identifying recurrence pheochromocytoma
[^18F]mFBG PET/CT imaging outperforms MRI and [^68 Ga]Ga-DOTA-TOC PET/CT in identifying recurrence pheochromocytoma
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[^18F]mFBG PET/CT 成像在识别复发性嗜铬细胞瘤方面优于 MRI 和 [^68 Ga]Ga-DOTA-TOC PET/CT
DOI：
10.1007/s00259-022-06064-5
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发表时间：
2022
影响因子：
9.1
通讯作者：
B. Keizer
中科院分区：
文献类型：
--
作者：
D. P. Suurd;A. Poot;R. Leeuwaarde;A. Windhorst;M. Vriens;B. Keizer
嗜铬细胞瘤是一种临床表现多种多样的神经内分泌肿瘤。功能成像用于确认嗜铬细胞瘤生化证据后通过CT或MRI发现的可疑病变[1]。用于神经内分泌肿瘤的功能成像技术有[123I]MIBG SPECT、[68Ga]Ga-DOTA-TOC/-NOC/-Tate PET/CT或[18F]FDOPA PET/CT[1-4]。相对较新的是使用[18F]mFBG PET/CT。最近，Wang和他的同事在一系列28例转移性嗜铬细胞瘤和副神经节瘤患者中展示了[18F]mFBG PET/CT比[68 Ga]Ga-DOTA-Tate PET/CT的优势。在此，我们报告一位27岁女性，因MAX基因突变导致双侧嗜铬细胞瘤而行双侧肾上腺全切除术后复发的生化证据。行MRI和[68Ga]Ga-DOTA-TOC PET/CT检查。MRI显示左侧肾上腺切除/肾切除腔内有两个可疑病灶，其中一个位于脾旁(图C，1)，一个位于椎旁。[68Ga]Ga-DOTA-TOC PET/CT不能证明第一个是嗜铬细胞瘤，因为脾总是显示[68Ga]Ga-DOTA-TOC高摄取(图A)。由于MRI上的发现对手术计划有影响，患者接受了[18F]mFBG PET/CT检查以确认。在注射146MBq[18F]mFBG(MIP，图B)60min后进行全身PET/CT扫描。PET/CT证实MRI阳性病变(图D和E，1-2)。此外，还发现了另外三个在MRI和[68Ga]Ga-DOTA-TOC PET/CT上都看不到的病变。一个病变不能从脾中分离出来(图1D，3)，两个位于手术夹附近(图F，4)。这位病人通过手术治疗成功。
Pheochromocytomas are neuroendocrine tumors with highly variable clinical presentation. Functional imaging is used to confirm suspicious lesions found via CT or MRI after biochemical evidence of a pheochromocytoma [1]. Functional imaging techniques used for neuroendocrine tumors are [123I] mIBG SPECT,[68 Ga] Ga-DOTA-TOC/-NOC/-TATE PET/CT, or [18F] FDOPA PET/CT [1–4]. Relatively new is the use of [18F] mFBG PET/CT. Recently, Wang and colleagues showed the advantages of [18F] mFBG PET/CT over [68 Ga] Ga-DOTA-TATE PET/CT in a series of 28 patients with metastatic pheochromocytomas and paragangliomas [5]. Here, we present a 27-year-old woman with biochemical evidence of recurrence of disease after bilateral total adrenalectomy due to bilateral pheochromocytoma as a result of a MAX gene mutation. A MRI and [68 Ga] Ga-DOTA-TOC PET/CT were performed. The MRI showed two suspicious lesions in the left adrenalectomy/nefrectomy cavity, of which one was adjacent to the spleen (Figure C, 1) and one paravertebral.[68 Ga] Ga-DOTA-TOC PET/CT was unable to prove that the first was a pheochromocytoma localization, as the spleen always shows high [68 Ga] Ga-DOTA-TOC uptake (Figure A). As the findings on MRI had implications for surgery planning, the patient underwent a [18F] mFBG PET/CT for confirmation. A whole-body PET/CT was acquired 60 min after injection of 146 MBq [18F] mFBG (MIP, Figure B). PET/CT confirmed the MRI-positive lesions (Figure D and E, 1-2). Furthermore, three additional lesions were identified that were not visible on MRI nor the [68 Ga] Ga-DOTA-TOC PET/CT. One lesion was not separately identifiable from the spleen (Fig. 1D, 3), and two were near surgery clips (Figure F, 4). The patient was successfully treated via surgery.