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Kim SH, Chang SJC, Dobri G, Strauss S, Lin E, Zavaletta V, Pannullo SC, Osborne JR, Schwartz TH, Knisely JPS, Ivanidze J. [68 Ga]-DOTATATE PET/MR-based evaluation of physiologic somatostatin receptor 2 expression in the adult pituitary gland as a function of age and sex in a prospective cohort. Pituitary 2023:10.1007/s11102-023-01329-0. [PMID: 37285059 DOI: 10.1007/s11102-023-01329-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 06/08/2023]
Abstract
PURPOSE The pituitary gland has the fourth highest physiologic avidity of [68 Ga]-DOTATATE. In order to guide our understanding of [68 Ga]-DOTATATE PET in clinical contexts, accurate characterization of the normal pituitary gland is first required. This study aimed to characterize the normal pituitary gland using dedicated brain [68 Ga]-DOTATATE PET/MRI as a function of age and sex. METHODS A total of 95 patients with a normal pituitary gland underwent brain [68 Ga]-DOTATATE PET examinations for the purpose of diagnosing CNS SSTR2 positive tumors (mean age: 58.9, 73% female). Maximum SUV of the pituitary gland was obtained in each patient. SUV of superior sagittal sinus was obtained to calculate normalized SUV score (SUVR) of the gland. The anatomic size of the gland was collected as maximum sagittal height (MSH). Correlations with age and sex were analyzed. RESULTS The mean SUV and SUVR of the pituitary gland were 17.6 (range: 7-59.5, SD = 7.1) and 13.8 (range: 3.3-52.6, SD = 7.2), respectively. Older females had significantly higher SUV of the pituitary gland compared to younger females. When stratified by age and sex, both older and younger females had significantly higher pituitary SUV than older males. SUVR did not differ significantly by age or sex. MSH of the pituitary gland in younger females was significantly greater than in younger males at all age cutoffs. CONCLUSION This study provides an empiric profiling of the physiological [68 Ga]-DOTATATE avidity of the pituitary gland. The findings suggest that SUV may vary by age and sex and can help guide the use of [68 Ga]-DOTATATE PET/MRI in clinical and research settings. Future studies can build on these findings to investigate further the relationship between pituitary biology and demographic factors.
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Affiliation(s)
- Sean H Kim
- Department of Radiology, New York-Presbyterian Hospital, Weill Cornell Medical Center, 525 E. 68Th St, New York, NY, 10021, USA
| | - Se Jung Chris Chang
- Department of Radiology, New York-Presbyterian Hospital, Weill Cornell Medical Center, 525 E. 68Th St, New York, NY, 10021, USA
| | - Georgiana Dobri
- Department of Endocrinology, Weill Cornell Medical Center, New York-Presbyterian Hospital, New York, NY, USA
| | - Sara Strauss
- Department of Radiology, New York-Presbyterian Hospital, Weill Cornell Medical Center, 525 E. 68Th St, New York, NY, 10021, USA
| | - Eaton Lin
- Department of Radiology, New York-Presbyterian Hospital, Weill Cornell Medical Center, 525 E. 68Th St, New York, NY, 10021, USA
| | - Vaz Zavaletta
- Department of Radiology, University of Colorado Hospital, Aurora, CO, USA
| | - Susan C Pannullo
- Department of Neurological Surgery, Weill Cornell Medical Center, New York-Presbyterian Hospital, New York, NY, USA
| | - Joseph R Osborne
- Department of Radiology, New York-Presbyterian Hospital, Weill Cornell Medical Center, 525 E. 68Th St, New York, NY, 10021, USA
| | - Theodore H Schwartz
- Department of Neurological Surgery, Weill Cornell Medical Center, New York-Presbyterian Hospital, New York, NY, USA
| | - Jonathan P S Knisely
- Department of Radiation Oncology, Weill Cornell Medical Center, New York-Presbyterian Hospital, New York, NY, USA
| | - Jana Ivanidze
- Department of Radiology, New York-Presbyterian Hospital, Weill Cornell Medical Center, 525 E. 68Th St, New York, NY, 10021, USA.
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Araujo-Castro M, Pascual-Corrales E, Alonso-Gordoa T, Molina-Cerrillo J, Martínez Lorca A. Papel de las pruebas de imagen con radionúclidos en el diagnóstico y tratamiento de los feocromocitomas y paragangliomas. ENDOCRINOL DIAB NUTR 2022. [DOI: 10.1016/j.endinu.2021.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Araujo-Castro M, Pascual-Corrales E, Alonso-Gordoa T, Molina-Cerrillo J, Martínez Lorca A. Role of imaging test with radionuclides in the diagnosis and treatment of pheochromocytomas and paragangliomas. ENDOCRINOL DIAB NUTR 2022; 69:614-628. [PMID: 36402734 DOI: 10.1016/j.endien.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/29/2021] [Indexed: 06/16/2023]
Abstract
Radionuclide imaging tests with [123I] Metaiodobenzylguanidine (MIBG), [18F] -fluorodeoxyglucose, [18F]-fluorodopa, or 68Ga-DOTA(0)-Tyr(3)-octreotate are useful for the diagnosis, staging and follow-up of pheochromocytomas (PHEOs) and paragangliomas (PGLs) (PPGLs). In addition to their ability to detect and localize the disease, they allow a better molecular characterization of the tumours, which is useful for planning targeted therapy with iodine-131 (131I) -labelled MIBG or with peptide receptor radionuclide therapy (PRRT) with [177Lu]-labelled DOTATATE or other related agents in patients with metastatic disease. In this review we detail the main characteristics of the radiopharmaceuticals used in the functional study of PPGLs and the role of nuclear medicine tests for initial evaluation, staging, selection of patients for targeted molecular therapy, and radiation therapy planning. It also offers a series of practical recommendations regarding the functional imaging according to the different clinical and genetic scenarios in which PPGLs occur, and on the indications and efficacy of therapy with [131I]-MIBG and 177Lu-DOTATATE.
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Affiliation(s)
- Marta Araujo-Castro
- Unidad de Neuroendocrinología, Servicio de Endocrinología y Nutrición, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, Madrid, Spain; Universidad de Alcalá, Departamento de Ciencias de la Salud, Madrid, Spain.
| | - Eider Pascual-Corrales
- Unidad de Neuroendocrinología, Servicio de Endocrinología y Nutrición, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Teresa Alonso-Gordoa
- Servicio de Oncología Médica, IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Javier Molina-Cerrillo
- Servicio de Oncología Médica, IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Alberto Martínez Lorca
- Servicio de Medicina Nuclear, IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain.
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Harley RJ, Lee JH, Ostrander BT, Finegersh A, Pham TB, Tawfik KO, Ren Y, Faraji F, Friedman RA. Local Tumor Behavior Associated With Survival Among Patients With Paraganglioma of the Head and Neck. OTO Open 2022; 6:2473974X221086872. [PMID: 35571573 PMCID: PMC9096223 DOI: 10.1177/2473974x221086872] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/27/2022] [Indexed: 11/17/2022] Open
Abstract
Objective The purpose of this study was to evaluate the utility of
ICD-O-3–classified local tumor behavior as a
prognosticator of head and neck paraganglioma (HNP) outcomes. Study Design Retrospective cohort study. Setting National Cancer Database between 2004 and 2016. Methods This study included patients aged ≥18 years who were diagnosed with HNP.
Clinical outcomes and clinicopathologic features were compared with regard
to local tumor behavior. Results Our study included 525 patients, of which the majority had HNP classified as
locally invasive (45.9%) or borderline (37.9%). The most common anatomic
sites involved were the carotid body (33.7%), intracranial regions (29.0%),
or cranial nerves (25.5%). Carotid body tumors were exclusively locally
invasive, whereas intracranial and cranial nerve HNP were overwhelmingly
benign or borderline (94% and 91%, respectively). One-fourth of patients
underwent pathologic analysis of regional lymph nodes, of which the majority
were positive for metastasis (80.6%). Metastasis to distant organs was twice
as common in patients with locally invasive tumors vs benign (15% vs 7.1).
For benign disease, surgery with radiotherapy (adjusted hazard ratio [aHR],
40.45; P = .006) and active surveillance (aHR, 24.23;
P = .008) were associated with worse survival when
compared with surgery alone. For locally invasive tumors, greater age (aHR,
1.07; P < .0001) and positive surgical margins (aHR,
4.13; P = .010) were predictors of worse survival, while
combined surgery and radiotherapy were predictors of improved survival vs
surgery alone (aHR, 0.31; P = .027). Conclusion While criteria for tumor behavior could not be defined, our results suggest
that such a classification system could be used to enhance HNP risk
stratification and guide clinical management decisions.
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Affiliation(s)
- Randall J. Harley
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego Health, San Diego, California, USA
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jason H. Lee
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego Health, San Diego, California, USA
| | - Benjamin T. Ostrander
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego Health, San Diego, California, USA
| | - Andrey Finegersh
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego Health, San Diego, California, USA
| | - Tammy B. Pham
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego Health, San Diego, California, USA
| | - Kareem O. Tawfik
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego Health, San Diego, California, USA
| | - Yin Ren
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego Health, San Diego, California, USA
| | - Farhoud Faraji
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego Health, San Diego, California, USA
| | - Rick A. Friedman
- Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego Health, San Diego, California, USA
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Pham D, Simiele E, Breitkreutz D, Capaldi D, Han B, Surucu M, Oderinde S, Vitzthum L, Gensheimer M, Bagshaw H, Chin A, Xing L, Chang DT, Kovalchuk N. IMRT and SBRT Treatment Planning Study for the First Clinical Biology-Guided Radiotherapy System. Technol Cancer Res Treat 2022; 21:15330338221100231. [PMID: 35579876 PMCID: PMC9118457 DOI: 10.1177/15330338221100231] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Purpose: The first clinical biology-guided radiation therapy (BgRT) system—RefleXionTM X1—was installed and commissioned for clinical use at our institution. This study aimed at evaluating the treatment plan quality and delivery efficiency for IMRT/SBRT cases without PET guidance. Methods: A total of 42 patient plans across 6 cancer sites (conventionally fractionated lung, head, and neck, anus, prostate, brain, and lung SBRT) planned with the EclipseTM treatment planning system (TPS) and treated with either a TrueBeam® or Trilogy® were selected for this retrospective study. For each Eclipse VMAT plan, 2 corresponding plans were generated on the X1 TPS with 10 mm jaws (X1-10mm) and 20 mm jaws (X1-20mm) using our institutional planning constraints. All clinically relevant metrics in this study, including PTV D95%, PTV D2%, Conformity Index (CI), R50, organs-at-risk (OAR) constraints, and beam-on time were analyzed and compared between 126 VMAT and RefleXion plans using paired t-tests. Results: All but 3 planning metrics were either equivalent or superior for the X1-10mm plans as compared to the Eclipse VMAT plans across all planning sites investigated. The Eclipse VMAT and X1-10mm plans generally achieved superior plan quality and sharper dose fall-off superior/inferior to targets as compared to the X1-20mm plans, however, the X1-20mm plans were still considered acceptable for treatment. On average, the required beam-on time increased by a factor of 1.6 across all sites for X1-10mm compared to X1-20mm plans. Conclusions: Clinically acceptable IMRT/SBRT treatment plans were generated with the X1 TPS for both the 10 mm and 20 mm jaw settings.
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Affiliation(s)
- Daniel Pham
- Department of Radiation Oncology, 6429Stanford University, Stanford, CA, USA
| | - Eric Simiele
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Dylan Breitkreutz
- Department of Radiation Oncology, 6429Stanford University, Stanford, CA, USA
| | - Dante Capaldi
- Department of Radiation Oncology, 6429Stanford University, Stanford, CA, USA
| | - Bin Han
- Department of Radiation Oncology, 6429Stanford University, Stanford, CA, USA
| | - Murat Surucu
- Department of Radiation Oncology, 6429Stanford University, Stanford, CA, USA
| | | | - Lucas Vitzthum
- Department of Radiation Oncology, 6429Stanford University, Stanford, CA, USA
| | - Michael Gensheimer
- Department of Radiation Oncology, 6429Stanford University, Stanford, CA, USA
| | - Hilary Bagshaw
- Department of Radiation Oncology, 6429Stanford University, Stanford, CA, USA
| | - Alex Chin
- Department of Radiation Oncology, 6429Stanford University, Stanford, CA, USA
| | - Lei Xing
- Department of Radiation Oncology, 6429Stanford University, Stanford, CA, USA
| | - D T Chang
- Department of Radiation Oncology, 6429Stanford University, Stanford, CA, USA
| | - Natalyia Kovalchuk
- Department of Radiation Oncology, 6429Stanford University, Stanford, CA, USA
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