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Licensed Unlicensed Requires Authentication Published by De Gruyter November 12, 2020

The utility of 68Ga-DOTATATE PET/CT in localizing primary/metastatic pheochromocytoma and paraganglioma in children and adolescents – a single-center experience

Sanjeet Kumar Jaiswal ORCID logo, Vijaya Sarathi, Gaurav Malhotra, Priya Hira, Ravikumar Shah, Virendra A. Patil, Abhay Dalvi, Gagan Prakash, Anurag R. Lila, Nalini S. Shah and Tushar Bandgar ORCID logo

Abstract

Objectives

Pediatric pheochromocytoma and paraganglioma (PPGL) are rare tumors with limited data on the diagnostic performance of 68Ga-DOTA(0)-Tyr(3)-octreotate positron emission tomography–computed tomography (68Ga-DOTATATE PET/CT). We have described our experience of 68Ga-DOTATATE PET/CT in overall and von Hippel Lindau (VHL)-associated pediatric PPGL and compared its sensitivity with that of 131I-meta-iodobenzyl-guanidine (131I-MIBG), 18F-fluorodeoxyglucose PET/CT (18F-FDG PET/CT), and contrast-enhanced CT (CECT).

Methods

Retrospective evaluation of consecutive PPGL patients (age: ≤20 years), who had undergone at least one functional imaging [131I-MIBG, 18F-FDG PET/CT, and/or 68Ga-DOTATATE PET/CT], was done. Composite of anatomical and all the performed functional imaging scans, image comparator (IC), was considered as the gold standard for sensitivity analysis.

Results

In a cohort of 32 patients (16 males, age at diagnosis: 16.4 ± 2.68 years), lesion-wise sensitivity of 68Ga-DOTATATE PET/CT (95%) was higher than that of both 18F-FDG-PET/CT (80%, p=0.027) and 131I-MIBG (65%, p=0.0004) for overall lesions, than that of 18F-FDG-PET/CT (100 vs. 67%, p=0.017) for primary PPG, and than that of 131I-MIBG (93 vs. 42%, p=0.0001) for metastases. In the VHL (n=14), subgroup, 68Ga-DOTATATE PET/CT had higher lesion-wise sensitivity (100%) compared to 18F-FDG PET/CT (74%, p=0.045) and 131I-MIBG (64%, p=0.0145).

Conclusions

In our pediatric PPGL cohort, overall lesion-wise sensitivity of 68Ga-DOTATATE PET/CT was higher than that of 18F–FDG PET/CT and 131I-MIBG scintigraphy. Hence, we recommend 68Ga-DOTATATE PET/CT as the preferred modality in pediatric PPGL. 68Ga-DOTATATE PET/CT may evolve as a preferred imaging modality for disease surveillance in VHL.


Corresponding author: Tushar Bandgar, MD, DM, Department of Endocrinology, Seth G.S. Medical College & KEM hospital, Parel, 4000012Mumbai, Maharashtra, India, Phone: (+91) 02224162917, Fax: (022) 24162883, E-mail:

Funding source: Scientific and Engineering Research Board

Award Identifier / Grant number: Grant# SB/SO/HS/041/2013

Acknowledgment

We acknowledge Vyankatesh Shivane, Neeta Doiphode, and Neelam Jaguste for administrative help in the conduct of the study.

  1. Research funding: This study was funded by the Scientific and Engineering Research Board (SERB), Department of Science and Technology, Government of India (Grant# SB/SO/HS/041/2013).

  2. Author contributions: Study design: Tushar Bandgar. Literature review, data collection, analysis, and drafting of the manuscript: Sanjeet Kumar Jaiswal and Ravikumar shah. Tushar Bandgar, Vijaya Sarathi, and other authors have reviewed, edited, and approved the final manuscript.

  3. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication. The authors have no conflict of interest to disclose.

  4. Informed consent: Considering the retrospective nature of the study waiver of informed consent was obtained for all individuals included in this study.

  5. Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standard.

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/jpem-2020-0354).

Received: 2020-06-11
Accepted: 2020-10-15
Published Online: 2020-11-12
Published in Print: 2021-01-27

© 2020 Walter de Gruyter GmbH, Berlin/Boston

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