Role of <scp>DOTATATE</scp>‐<scp>PET</scp>/<scp>CT</scp> in preoperative assessment of phaeochromocytoma and paragangliomas

Gild, Matti; Naik, Nikita; Hoang, Jeremy; Hsiao, Edward; McGrath, Rachel T.; Sywak, Mark; Sidhu, Stan; Delbridge, Leigh; Robinson, Bruce G.; Schembri, Geoffrey; Clifton‐Bligh, Roderick

doi:10.1111/cen.13737

Cited by 35 publications

(26 citation statements)

References 30 publications

(52 reference statements)

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“…In a recent non-comparative study from the Royal North Shore Hospital in Australia, 68 Ga-DOTATATE PET/CT was evaluated for initial staging (n = 28) and restaging (n = 18, including eight metastatic cases) for PHEOs and for initial staging (n = 8) and restaging (n = 18, including four metastatic cases) for PGLs. Overall, 68 Ga-DOTATATE PET/CT had a sensitivity of 84% for PHEO (21/24) and 100% (7/7) for PGL (Gild et al 2018). Further, 68 Ga-DOTATATE PET/CT resulted in change of management in 50% PHEOs (23/46) and 44% (12/27) PGLs.…”

Section: :11mentioning

confidence: 94%

Molecular imaging and radionuclide therapy of pheochromocytoma and paraganglioma in the era of genomic characterization of disease subgroups

Taïeb

Jha

Treglia

2019

Endocrine-Related Cancer

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In recent years, advancement in genetics has profoundly helped to gain a more comprehensive molecular, pathogenic, and prognostic picture of pheochromocytomas and paragangliomas (PPGLs). Newly discovered molecular targets, particularly those that target cell membranes or signaling pathways have helped move nuclear medicine in the forefront of PPGL precision medicine. This is mainly based on the introduction and increasing experience of various PET radiopharmaceuticals across PPGL genotypes quickly followed by implementation of novel radiotherapies and revised imaging algorithms. Particularly, 68Ga-labeled-SSAs have shown excellent results in the diagnosis and staging of PPGLs and in selecting patients for PRRT as a potential alternative to 123/131I-MIBG theranostics. PRRT using 90Y/177Lu-DOTA-SSAs has shown promise for treatment of PPGLs with improvement of clinical symptoms and/or disease control. However, more well-designed prospective studies are required to confirm these findings, in order to fully exploit PRRT’s antitumoral properties to obtain the final FDA approval. Such an approval has recently been obtained for high‐specific-activity 131I-MIBG for inoperable/metastatic PPGL. The increasing experience and encouraging preliminary results of these radiotherapeutic approaches in PPGLs now raises an important question of how to further integrate them into PPGL management (e.g. monotherapy or in combination with other systemic therapies), carefully taking into account the PPGLs locations, genotypes, and growth rate. Thus, targeted radionuclide therapy (TRT) should preferably be performed at specialized centers with an experienced interdisciplinary team. Future perspectives include the introduction of dosimetry and biomarkers for therapeutic responses for more individualized treatment plans, α-emitting isotopes, and the combination of TRT with other systemic therapies.

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Section: :11mentioning

confidence: 94%

Molecular imaging and radionuclide therapy of pheochromocytoma and paraganglioma in the era of genomic characterization of disease subgroups

Taïeb

Jha

Treglia

2019

Endocrine-Related Cancer

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“…Elevated metanephrine/normetanephrine levels should then prompt adrenal imaging, usually by computed tomography or magnetic resonance imaging. 68 Ga‐DOTATATE‐PET imaging may be appropriate in selected cases for the diagnosis of local recurrence or metastases (which are rare in MEN2/3) …”

Section: Men2 and Men3mentioning

confidence: 99%

“…As such, any MEN2/3 patient undergoing preoperative assessment for thyroidectomy should have serum metanephrine and normetanephrine measurement or, if unavailable, urine catecholamines . Depending on availability, a 68 Ga‐DOTATATE‐PET scan should be considered due to its high sensitivity for smaller tumours . Unrecognised PC in surgery is associated with significant morbidity and mortality.…”

Section: Men2 and Men3mentioning

confidence: 99%

“…68 Ga-DOTA-TATE-PET imaging may be appropriate in selected cases for the diagnosis of local recurrence or metastases (which are rare in MEN2/3). 21 Treatment MEN2 and MEN3 patients with RET mutations require a prophylactic thyroidectomy, that is, ideally before MTC has developed. The timing of this is based on risk stratification of the RET mutation described by the American Thyroid Association (Table 1).…”

Section: Men2 and Men3mentioning

confidence: 99%

“…17 Depending on availability, a 68 Ga-DOTATATE-PET scan should be considered due to its high sensitivity for smaller tumours. 21 Unrecognised PC in surgery is associated with significant morbidity and mortality. Patients with PC require alpha blockade with or without beta blockade prior to and during surgery.…”

Section: Men2 and Men3mentioning

confidence: 99%

See 2 more Smart Citations

Multiple endocrine neoplasia: an update

Mcdonnell

Gild

Clifton‐Bligh

et al. 2019

Internal Medicine Journal

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The multiple endocrine neoplasia (MEN) syndromes include MEN1, MEN2 (formerly MEN2A), MEN3 (formerly MEN2B) and the recently identified MEN4. Clinical presentations are varied and often relate to the overproduction of specific hormones. Understanding the genetics of each syndrome assists in determining screening timelines. Treatments for each manifestation are dependent on location, risk of recurrence or malignancy, hormone excess and surgical morbidity. Multidisciplinary management should include geneticists, genetic counsellors, endocrinologists and endocrine surgeons.

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