Gallium-68-DOTA-NOC PET/CT appears to be a highly sensitive and specific modality for the detection of gastroenteropancreatic NET. It is better than conventional imaging for the evaluation of gastroenteropancreatic NETs and can have a significant impact on patient management.
In this article, we describe the various causes and patterns of skeletal muscle FDG uptake. Familiarity with these patterns is essential for proper interpretation of clinical FDG PET/CT images.
Ga-DOTA-NOC PET-CT seems to be superior to F-FDG PET-CT for imaging GEP-NETs. However, their role seems to be complementary because combination of Ga-DOTA-NOC PET-CT and F-FDG PET-CT in such patients helps demonstrate the total disease burden and segregate them to proper therapeutic groups.
Diuretic (18)F-FDG PET/CT is highly sensitive and specific and plays an important role in improving detection of the primary tumour and locoregional staging of urinary bladder tumours. Diuretic (18)F-FDG PET/CT demonstrated a higher diagnostic value when compared with CECT in these patients.
The purpose of this study was to evaluate the role of 68 Ga-labeled DOTANOC PET/CT for baseline evaluation of patients with head and neck paragangliomas (HNPs). Methods: The data for 26 patients (mean age 6 SD, 34.3 6 10.4 y; 50% men) with known or suspected HNPs who underwent 68 Ga-DOTANOC PET/CT for staging were retrospectively analyzed. PET/CT was performed after intravenous injection of 132-222 MBq of 68 Ga-DOTANOC. The images were evaluated by 2 experienced nuclear medicine physicians in consensus, both qualitatively and quantitatively. The PET/CT findings were grouped as HNPs, paraganglioma at other sites (non-HNPs), and metastatic disease. The size and maximum standardized uptake values (SUVmax) were measured for all lesions. All of the patients also underwent whole-body 131 I-metaiodobenzylgunanidine ( 131 I-MIBG) scintigraphy and conventional imaging (CT/MR imaging) of the head and neck region. Their results were compared with those of 68 Ga-DOTANOC PET/CT. Results: 68 Ga-DOTANOC PET/CT findings were positive in all 26 patients, and 78 lesions were detected. PET/CT imaging demonstrated 45 HNPS, 10 non-HNPs, and 23 metastatic sites. Fifteen patients (57.6%) had more than one site of disease on PET/ CT. Among 45 HNPs, 26 were carotid body tumors (CBTs), 15 glomus jugulare, 3 glomus tympanicum, and 1 laryngeal paraganglioma. A positive correlation was seen between size and SUVmax of HNPs (r 5 0.323; P 5 0.030). The SUVmax of the CBTs was higher than that of jugulotympanic paragangliomas (P 5 0.026). No correlation was seen between size and SUVmax (r 5 0.069; P 5 0.854) of non-HNPs. The size and SUVmax of non-HNPs were significantly less than those of HNPs (P 5 0.029 and 0.047, respectively). 131 I-MIBG scintigraphy showed only 30 of the 78 lesions and was inferior to PET/CT (P , 0.0001). Conventional imaging (CT/MR imaging) was positive for 42 of 49 head and neck lesions and was inferior to PET/CT on direct comparison (P 5 0.015). A combination of CT/MR imaging and 131 I-MIBG scintigraphy detected only 53 of 78 (67.9%) lesions and was also inferior to PET/CT (P , 0.0001). Conclusion: 68 Ga-DOTANOC PET/CT is useful for the baseline evaluation of patients with HNPs and can demonstrate synchronous paragangliomas at other sites and distant metastases. It is superior to 131 I-MIBG scintigraphy and conventional imaging (CT/MR imaging) for this purpose.
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