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Article

Performances of Functional and Anatomic Imaging Modalities in Succinate Dehydrogenase A-Related Metastatic Pheochromocytoma and Paraganglioma

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Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20814, USA
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Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, MD 20814, USA
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Nuclear Medicine Department, Radiology and Imaging Sciences, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, MD 20814, USA
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Positron Emission Tomography Department, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, MD 20814, USA
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Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
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Laboratory of Pathology, National Cancer Institute, NIH, Bethesda, MD 20814, USA
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Developmental Therapeutics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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Early Clinical Trials Development Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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Surgical Oncology Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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Targeted Radionuclide Therapy Section, Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Radiological Science, Johns Hopkins Medicine, Baltimore, MD 21287, USA
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Department of Nuclear Medicine, La Timone University Hospital, CERIMED, Aix-Marseille University, 13273 Marseille, France
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Department of Radiology, Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
*
Author to whom correspondence should be addressed.
Academic Editors: Tadashi Watabe and Frederik Lars Giesel
Cancers 2022, 14(16), 3886; https://doi.org/10.3390/cancers14163886
Received: 12 July 2022 / Revised: 27 July 2022 / Accepted: 6 August 2022 / Published: 11 August 2022
(This article belongs to the Special Issue Molecular Imaging and Radio-Nuclide Therapy in Cancers)
Pheochromocytoma and paraganglioma (PPGL) are rare neuroendocrine cancers which carry the risk of metastatic disease. Pathogenic variants in the succinate dehydrogenase subunit A gene (SDHA) have been shown to cause metastatic disease, occurring in various regions of the body. Imaging is an early and vital step in the diagnosis and clinical care of these patients. The study here identifies which imaging modality among positron emission tomography (PET), computed tomography (CT), and magnetic resonance imaging (MRI) performs better in localizing metastatic PPGL lesions related to SDHA. The study identified that 68Ga-DOTATATE PET/CT performed best at overall lesion detection; however, 18F-FDG PET/CT performed better in certain anatomic regions of the body. A combined approach with 68Ga-DOTATATE and 18F-FDG would optimize care and guide clinicians in selecting the appropriate interventions and therapies.
The study identifies the importance of positron emission tomographic (PET) and anatomic imaging modalities and their individual performances in detecting succinate dehydrogenase A (SDHA)-related metastatic pheochromocytoma and paraganglioma (PPGL). The detection rates of PET modalities—68Ga-DOTATATE, 18F-FDG, and 18F-FDOPA—along with the combination of computed tomography (CT) and magnetic resonance imaging (MRI) are compared in a cohort of 11 patients with metastatic PPGL in the setting of a germline SDHA mutation. The imaging detection performances were evaluated at three levels: overall lesions, anatomic regions, and a patient-by-patient basis. 68Ga-DOTATATE PET demonstrated a lesion-based detection rate of 88.6% [95% confidence interval (CI), 84.3–92.5%], while 18F-FDG, 18F-FDOPA, and CT/MRI showed detection rates of 82.9% (CI, 78.0–87.1%), 39.8% (CI, 30.2–50.2%), and 58.2% (CI, 52.0–64.1%), respectively. The study found that 68Ga-DOTATATE best detects lesions in a subset of patients with SDHA-related metastatic PPGL. However, 18F-FDG did detect more lesions in the liver, mediastinum, and abdomen/pelvis anatomic regions, showing the importance of a combined approach using both PET modalities in evaluating SDHA-related PPGL. View Full-Text
Keywords: pheochromocytoma; paraganglioma; metastatic; SDHA; PET; CT; MRI; 68Ga-DOTATATE; 18F-FDG pheochromocytoma; paraganglioma; metastatic; SDHA; PET; CT; MRI; 68Ga-DOTATATE; 18F-FDG
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MDPI and ACS Style

Patel, M.; Jha, A.; Ling, A.; Chen, C.C.; Millo, C.; Kuo, M.J.M.; Nazari, M.A.; Talvacchio, S.; Charles, K.; Miettinen, M.; Del Rivero, J.; Chen, A.P.; Nilubol, N.; Lin, F.I.; Civelek, A.C.; Taïeb, D.; Carrasquillo, J.A.; Pacak, K. Performances of Functional and Anatomic Imaging Modalities in Succinate Dehydrogenase A-Related Metastatic Pheochromocytoma and Paraganglioma. Cancers 2022, 14, 3886. https://doi.org/10.3390/cancers14163886

AMA Style

Patel M, Jha A, Ling A, Chen CC, Millo C, Kuo MJM, Nazari MA, Talvacchio S, Charles K, Miettinen M, Del Rivero J, Chen AP, Nilubol N, Lin FI, Civelek AC, Taïeb D, Carrasquillo JA, Pacak K. Performances of Functional and Anatomic Imaging Modalities in Succinate Dehydrogenase A-Related Metastatic Pheochromocytoma and Paraganglioma. Cancers. 2022; 14(16):3886. https://doi.org/10.3390/cancers14163886

Chicago/Turabian Style

Patel, Mayank, Abhishek Jha, Alexander Ling, Clara C. Chen, Corina Millo, Mickey J. M. Kuo, Matthew A. Nazari, Sara Talvacchio, Kailah Charles, Markku Miettinen, Jaydira Del Rivero, Alice P. Chen, Naris Nilubol, Frank I. Lin, Ali Cahid Civelek, David Taïeb, Jorge A. Carrasquillo, and Karel Pacak. 2022. "Performances of Functional and Anatomic Imaging Modalities in Succinate Dehydrogenase A-Related Metastatic Pheochromocytoma and Paraganglioma" Cancers 14, no. 16: 3886. https://doi.org/10.3390/cancers14163886

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