Superiority of 68Ga-DOTATATE over 18F-FDG and anatomic imaging in the detection of succinate dehydrogenase mutation (SDHx )-related pheochromocytoma and paraganglioma in the pediatric population

Abstract

Our preliminary study demonstrates the superiority of Ga-DOTATATE PET/CT in localization of SDHx-related PPGLs in pediatric population compared toF-FDG PET/CT and CT/MR imaging with the exception of abdominal (excluding adrenal and liver) lesions, and suggests that it might be considered as a first-line imaging modality in pediatric patients with SDHx-related PPGLs.

Performance of 68Ga-DOTA–Conjugated Somatostatin Receptor–Targeting Peptide PET in Detection of Pheochromocytoma and Paraganglioma: A Systematic Review and Metaanalysis

“…Thus, 13 studies were included in the qualitative synthesis. We further excluded 4 studies that had exclusive patient populations: SDHB mutation (22), SDHx mutation in pediatric patients (24), sporadic type (23), and polycythemia/paraganglioma syndrome (45); inclusion of those studies might hinder generalization of the results. Therefore, 9 studies (215 patients) with no specific inclusion criteria for subtype were included in the metaanalysis (13)(14)(15)(16)(17)(18)(19)(20)(21), with the assumption that this pooled population might reflect patients with unknown genetic status in clinical practice.…”

“…Study and clinicopathologic characteristics are described in Tables 1 and 2, respectively. Seven studies used histopathology and BVC as the reference standard (13,(17)(18)(19)(20)(21)45), whereas 6 used only BVC (14)(15)(16)(22)(23)(24). The imaging modalities used for BVC included CT, MRI, 18 F-FDG PET, 18 F-FDOPA PET, and MIBG scintigraphy.…”

“…The imaging modalities used for BVC included CT, MRI, 18 F-FDG PET, 18 F-FDOPA PET, and MIBG scintigraphy. 68 Ga-DOTA-SST PET was performed for primary staging in 4 (15,(18)(19)(20), restaging in 2 (22,45), and staging or restaging in 7 studies (13,14,16,17,21,23,24). Radioligands were DOTATATE in 9 (13-15,18,21-24,45), DOTATOC in 2 (16,17), and DOTANOC in 2 studies (19,20).…”

“…Regarding the patient selection domain, 3 studies had an unclear risk of bias because they were retrospective, and it was not reported whether patients were consecutively enrolled (16)(17)(18). There was a high concern of applicability in 4 studies, as they only included patients with a specific genetic status or phenotypic subtype (15,22,24,45). Regarding the index test domain, there was an unclear risk of bias in 3 studies, as it was unclear whether the index test was interpreted without knowledge of the reference standard (14,18,21).…”

“…Because PPGLs express high levels of somatostatin receptor (SSTR) (10)(11)(12), 68 Ga-DOTA-conjugated somatostatin receptortargeting peptides ( 68 Ga-DOTA-SST) PET have shown an excellent lesion-based accuracy in detection of PPGLs (13)(14)(15)(16)(17)(18)(19)(20)(21). Recent publications suggest that 68 Ga-DOTA-SST PET provides a high detection rate across a wide range of mutations (22)(23)(24)(25). However, because of the small number of subjects in individual studies, it is difficult to conclude a higher level of evidence.…”