1
|
Wang P, Li T, Cui Y, Zhuang H, Li F, Tong A, Jing H. 18 F-MFBG PET/CT Is an Effective Alternative of 68 Ga-DOTATATE PET/CT in the Evaluation of Metastatic Pheochromocytoma and Paraganglioma. Clin Nucl Med 2023; 48:43-48. [PMID: 36252940 DOI: 10.1097/rlu.0000000000004447] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE The current guidelines state that the functional imaging choice in the evaluation of metastatic pheochromocytoma and paraganglioma (PPGL) is 68 Ga-DOTATATE PET/CT. 18 F-meta-fluorobenzylguanidine ( 18 F-MFBG) is a new PET tracer and an analog of meta-iodobenzylguanidine (MIBG). This study aimed to compare 18 F-MFBG and 68 Ga-DOTATATE PET/CT in patients with metastatic PPGL. PATIENTS AND METHODS Twenty-eight patients with known metastatic PPGL were prospectively recruited for this study. All patients underwent both 18 F-MFBG and 68 Ga-DOTATATE PET/CT studies within 1 week. Lesion numbers detected were compared between these 2 studies. RESULTS 18 F-MFBG PET/CT was positive for detecting metastases in all patients, whereas positive results of 68 Ga-DOTATATE PET/CT were in 27 (96.4%) patients. A total of 686 foci of metastatic lesions were detected by both 18 F-MFBG and 68 Ga-DOTATATE imaging. In addition, 33 foci of abnormal activity were only detected by 18 F-MFBG, whereas 16 foci were only shown on 68 Ga-DOTATATE PET/CT. CONCLUSIONS Our data suggest that 18 F-MFBG PET/CT is an effective imaging method in the evaluation of metastatic PPGL and could be alternative of 68 Ga-DOTATATE PET/CT in this clinical setting.
Collapse
Affiliation(s)
- Peipei Wang
- From the Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine
| | - Tuo Li
- From the Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine
| | - Yuying Cui
- Department of Endocrinology and Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongming Zhuang
- Department of Radiology, Children's Hospital of Philadelphia University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Fang Li
- From the Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine
| | - Anli Tong
- Department of Endocrinology and Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongli Jing
- From the Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine
| |
Collapse
|
2
|
Increased 68Ga-DOTATATE Uptake in Supraclavicular Brown Adipose Tissue. Clin Nucl Med 2022; 47:1112-1113. [PMID: 36342799 DOI: 10.1097/rlu.0000000000004405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
ABSTRACT Characterization of brown adipose tissue (BAT) 18F-FDG uptake has been well reported; however, 68Ga-DOTA-conjugated somatostatin receptor targeting peptides uptake in BAT is rarely documented. Herein, we report an interesting case of increased 68Ga-DOTATATE uptake in supraclavicular BAT in a young boy with paroxysmal hypertension. The low body mass index and increased perfusion of BAT in response to cold may be significant influencing factors.
Collapse
|
3
|
Comparison of 18 F-MFBG and 68 Ga-DOTATATE PET/CT in the Imaging of Metastatic Paraganglioma and Pheochromocytoma. Clin Nucl Med 2022; 47:e735-e737. [PMID: 35777982 DOI: 10.1097/rlu.0000000000004314] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
ABSTRACT Two men with metastatic paraganglioma/pheochromocytoma underwent PET/CT examination in our hospital to understand the treatment effect and progression of the disease. Both patients had previously been treated with 131 I-MIBG, and at this evaluation, both of them underwent 68 Ga-DOTATATE and 18 F-MFBG PET/CT. The 68 Ga-DOTATATE PET/CT showed more metastases in the images of these 2 patients. This case highlighted that 68 Ga-DOTATATE PET/CT is superior to 18 F-MFBG PET/CT in detecting metastases from paraganglioma and pheochromocytoma in these 2 patients.
Collapse
|
4
|
Lu Y. Heterogeneous Head and Neck Paraganglioma With Distinct Features on 123 I-MIBG and 68 Ga-DOTATATE Images. Clin Nucl Med 2022; 47:813-814. [PMID: 35353764 DOI: 10.1097/rlu.0000000000004147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT A 37-year-old man has palpable bilateral carotid body paragangliomas, larger on the right. The right-sided tumor is avid on both 123 I-MIBG and 68 Ga-DOTATATE PET/CT images. The left-sided tumor is only avid on 68 Ga-DOTATATE PET/CT, but not 123 I-MIBG scan. This case illustrates the heterogeneous features of carotid body paragangliomas.
Collapse
Affiliation(s)
- Yang Lu
- From the Division of Diagnostic Imaging, Department of Nuclear Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| |
Collapse
|
5
|
Wang P, Hou G, Jing H, Zhuang H, Li F. Similar Findings on 18F-MFBG PET/CT and 68Ga-DOTATATE PET/CT in a Patient With Widespread Metastatic Pheochromocytoma. Clin Nucl Med 2022; 47:451-453. [PMID: 35020650 DOI: 10.1097/rlu.0000000000003997] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT A 27-year-old woman with known malignant pheochromocytoma was enrolled in a clinical trial to compare efficacy of 68Ga-DOTATATE PET/CT and 18F-MFBG PET/CT. Images from both studies detected similar number of the metastatic lesions. In addition, both studies detected more lesions than 131I-MIBG imaging.
Collapse
Affiliation(s)
| | | | | | - Hongming Zhuang
- Department of Radiology, Children's Hospital of Philadelphia University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | | |
Collapse
|
6
|
Jin X, Li F, Chen L, Jing H. Breast Carcinoma Shown on 99mTc-HYNIC-TOC Study Performed to Evaluate Tumor-Induced Osteomalacia. Clin Nucl Med 2022; 47:197-199. [PMID: 34406185 DOI: 10.1097/rlu.0000000000003861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT A 74-year-old woman with a history of suspected tumor-induced osteomalacia underwent 99mTc-HYNIC-TOC scintigraphy to search potential culprit tumor. The images showed one in the middle shaft of left femur without corresponding morphology change on the CT portion of the subsequent SPECT/CT images. The patient declined surgical exploration of the left femur. Another activity was in the right breast, which was resected and pathologically confirmed as breast carcinoma. Postsurgically, the patient's symptoms were not improved. Four years later, a repeat 99mTc-HYNIC-TOC scintigraphy showed more prominent activity in the left femur with gross abnormality on the corresponding CT images.
Collapse
Affiliation(s)
- Xiaona Jin
- From the Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | | | | | | |
Collapse
|
7
|
Hou G, Jiang Y, Li F, Zhu Z, Jing H. Site-based performance of 131I-MIBG imaging and 99mTc-HYNIC-TOC scintigraphy in the detection of nonmetastatic extra-adrenal paraganglioma. Nucl Med Commun 2022; 43:32-41. [PMID: 34570039 PMCID: PMC8654250 DOI: 10.1097/mnm.0000000000001490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/14/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to evaluate the performance of 131I-metaiodobenzylguanidine (MIBG) imaging to detect nonmetastatic extra-adrenal paragangliomas at their respective sites (abdominal vs. thoracic vs. head and neck vs. urinary bladder), and compare it with that of 99mTc-hydrazinonicotinyl-tyr3-octreotide (HYNIC-TOC) scintigraphy. METHODS We retrospectively analyzed 235 patients with nonmetastatic extra-adrenal paragangliomas who underwent preoperative 131I-MIBG imaging or 99mTc-HYNIC-TOC scintigraphy. Of all 235 patients, 145 patients underwent both imaging procedures, 16 patients 131I-MIBG imaging only and 74 patients 99mTc-HYNIC-TOC scintigraphy only. RESULTS The overall sensitivity of 131I-MIBG and 99mTc-HYNIC-TOC imaging to detect extra-adrenal paragangliomas regardless of tumor sites was 75.8% (122/161) and 67.6% (148/219), respectively (P = 0.082). However, when stratified by tumor sites, 131I-MIBG imaging showed a significant improvement in the detection of extra-adrenal abdominal paragangliomas with a sensitivity of 90.3% (103/114), which was significantly higher than that of 99mTc-HYNIC-TOC scintigraphy (67.6% (96/142); P = 0.000). In addition, the intensity of tracer uptake in the extra-adrenal abdominal paragangliomas with 131I-MIBG imaging was evidently higher than with 99mTc-HYNIC-TOC scintigraphy. The sensitivity of 131I-MIBG imaging and 99mTc-HYNIC-TOC scintigraphy to detect urinary bladder, head and neck, and thoracic paragangliomas were 18.7 vs. 18.5% (P = 1.000); 17.4% vs. 84.6% (P = 0.000) and 60% vs. 94.4% (P = 0.030), respectively. CONCLUSIONS 131I-MIBG imaging could become the first-line investigation modality in patients with extra-adrenal abdominal paragangliomas. However, 99mTc-HYNIC-TOC scintigraphy has high sensitivity and is superior to 131I-MIBG imaging for detecting head & neck and thoracic paraganglioma. Both 131I-MIBG imaging and 99mTc-HYNIC-TOC scintigraphy have poor performance for detecting urinary bladder paragangliomas.
Collapse
Affiliation(s)
- Guozhu Hou
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
- Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing, China
| | - Yuanyuan Jiang
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
- Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing, China
| | - Fang Li
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
- Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing, China
| | - Zhaohui Zhu
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
- Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing, China
| | - Hongli Jing
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
- Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing, China
| |
Collapse
|
8
|
May G, Hegde A, Murphy C, St George EJ. Spinal paraganglioma presenting with raised intracranial pressure: a note on the diagnosis and post-operative management. Br J Neurosurg 2021:1-4. [PMID: 34927505 DOI: 10.1080/02688697.2021.2016617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 09/23/2021] [Accepted: 12/05/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Spinal paragangliomas are tumors of neuroendocrine origin that present with symptoms of mass effect or neurosecretion but rarely involve the central nervous system. Raised intracranial pressure and papilledema are therefore unusual presentations of a spinal paraganglioma. METHODS We review the case of a 54-year-old man who presented with headache and visual disturbance. Fundoscopy confirmed papilledema with normal intracranial imaging. Neuraxis imaging revealed a lumbar intradural extramedullary tumor and pathological analysis confirmed a WHO Grade I spinal paraganglioma. The tumor was resected and post operatively his vison improved with resolution of optic disc swelling. CONCLUSIONS Raised intracranial pressure and papilledema are unusual clinical manifestations of spinal tumors and imaging the entire neuraxis can be valuable.
Collapse
Affiliation(s)
- Gareth May
- Department of Neurosurgery, Institute of Neurological Sciences, Glasgow, UK
| | - Ajay Hegde
- Department of Neurosurgery, Institute of Neurological Sciences, Glasgow, UK
- Department of Neurosurgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Claire Murphy
- Department of Ophthalmology, University Hospital Hairmyres, Glasgow, UK
| | - Edward J St George
- Department of Neurosurgery, Institute of Neurological Sciences, Glasgow, UK
| |
Collapse
|
9
|
Zheng K, Zhu S, Chen L, Li F, Jing H. Paraganglioma From Vaginal Wall Revealed by 131I-MIBG Scan. Clin Nucl Med 2021; 46:691-693. [PMID: 33661199 DOI: 10.1097/rlu.0000000000003574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Vaginal paraganglioma is very rare. Most patients first presented irregular heavy menses and abnormal vaginal bleeding. The accurate diagnosis can only be made pathologically. Here we report a case of paraganglioma arising from vaginal wall in a 44-year-old woman who only presented catecholamine-related symptoms. The lesion had negative 99mTc-HYNIC-TOC (hydrazinonicotinyl-Tyr3-octreotide) activity but positive on 131I MIBG scan. Paraganglioma was highly suspected, which was confirmed by pathological and immunohistochemical findings after surgical resection of the lesion.
Collapse
Affiliation(s)
- Kun Zheng
- From the Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College; and Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing, China
| | | | | | | | | |
Collapse
|
10
|
Wang W, Dong D, Wen J, Li H. A 10-year observational single-center study of retroperitoneal unicentric Castleman disease. Medicine (Baltimore) 2021; 100:e25088. [PMID: 33725899 PMCID: PMC7969295 DOI: 10.1097/md.0000000000025088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 02/17/2021] [Indexed: 01/05/2023] Open
Abstract
Diagnosis of unicentric Castleman disease (UCD) is not easy before the resection and obtainment of pathological result. We retrospectively summarized 10-year experience of clinical evaluation and management for retroperitoneal UCD in Peking Union Medical College Hospital (PUMCH) between December 1, 2009 and December 31, 2019. Seventy two UCD patients with pathological diagnosis after resection were screened out. Among them 25 patients had retroperitoneal UCD. The average age of the 25 patients was 43.80 ± 12.79, and 52.00% were male. No patients had systemic symptoms, and 1 patient got preoperative treatment. The average size of masses was 5.59 ± 2.86 cm. The UCD sites included kidney, adrenal area, perinephric area, pancreas, peripancreatic area, area of descending part of duodenum, periaortic area or beside iliac artery, and others. The masses presented different degree of enhancement on CT scans and hypoecho or isoecho on ultrasound. Increased metabolism could be found on 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT). Some patients had positive results on somatostatin receptor imaging, but none had positive results on 131I-metaiiodo-benzylguanidine (131I-MIBG). Some patients presented the elevated level of interleukin-6 (IL-6), 24hour-urinary catecholamine and tumor markers. All the patients received complete resection of masses and 96.00% had hyaline-vascular type pathology except 1 patient (plasma cell-type). Ninety two percent patients received a long-term follow-up with an average follow-up time of 35.48 ± 33.90 months. No patients died or experienced relapse during follow-up. Differential diagnosis of retroperitoneal UCD may be difficult according to imaging and laboratorial examinations. Differential diagnosis with pheochromocytomas/paragangliomas should be taken into special consideration. Different imaging examinations, such as CT/MRI, 18F-PET/CT, somatostatin receptor imaging and 131I-MIBG, can be combined for differential analysis. Complete resection is the best treatment and could provide a final pathological diagnosis.
Collapse
|
11
|
Ding J, Cheng X, Hou G, Jing H, Huo L. Adrenal Castleman Disease on 99mTc-HYNIC-TOC Scan and FDG PET/CT. Clin Nucl Med 2021; 46:71-73. [PMID: 32956111 DOI: 10.1097/rlu.0000000000003271] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Adrenal Castleman disease is very rare. We reported image findings of a right adrenal mass in a 75-year-old man on Tc-HYNIC-TOC scan and FDG PET/CT. There was obviously elevated Tc-HYNIC-TOC activity, but the intensity of FDG activity was remarkable. Pheochromocytoma was initially suspected. However, pathology from resected specimen showed adrenal Castleman disease.
Collapse
Affiliation(s)
- Jie Ding
- From the Department of Nuclear Medicine and Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and PUMC, Beijing, China
| | | | | | | | | |
Collapse
|
12
|
Vukomanovic V, Matovic M, Djukic A, Ignjatovic V, Vuleta K, Djukic S, Simic Vukomanovic I. THE ROLE OF TUMOR-SEEKING RADIOPHARMACEUTICALS IN THE DIAGNOSIS AND MANAGEMENT OF ADRENAL TUMORS. ACTA ENDOCRINOLOGICA-BUCHAREST 2020; 16:316-323. [PMID: 33363653 DOI: 10.4183/aeb.2020.316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Context The variety of tumor-seeking radiopharmaceuticals, which are currently in clinical use, may have a potential role as imaging agents for adrenal gland tumors, due to physiological characteristics of this organ. Objective The purpose of this study was to evaluate the diagnostic potential of 99mTc-HYNIC-TOC, 99mTc(V)-DMSA, and 99mTc-MIBI in the assessment of adrenal tumors, by correlating with imaging findings and histopathologic results. Design The research is designed as a cross-sectional prospective study. Patients and method The study included 50 patients with adrenal tumors (19 hormone-secreting and 31 nonfunctioning) and 23 controls without adrenal involvement. In all patients, single-photon emission computed tomography (SPECT) was performed, using qualitative and semiquantitative analysis. The tumor to non-tumor tracer uptake was conducted by using a region-of-interest technique. Adrenal to background (A/B) ratio was calculated in all cases. Results 99mTc-HYNIC-TOC scintigraphy showed a high statistical significance between A/B ratios, while other two tracers resulted in a lower sensitivity, specificity and accuracy. Futhermore, 99mTc-HYNIC-TOC could have a high diagnostic yield to detect adrenal tumors (the receiver-operating-characteristic curve analysis, A/B ratio cut-off value of 8.40). Conclusion A semiquantitative SPECT analysis showed that 99mTc-HYNIC-TOC is a highly sensitive tumor-seeking agent for the accurate localization of adrenal tumors.
Collapse
Affiliation(s)
- V Vukomanovic
- Clinical Center Kragujevac - Nuclear Medicine Department, University of Kragujevac, Faculty of Medical Sciences - Kragujevac, Serbia.,Department of Nuclear Medicine and Oncology, Kragujevac, Serbia
| | - M Matovic
- Clinical Center Kragujevac - Nuclear Medicine Department, University of Kragujevac, Faculty of Medical Sciences - Kragujevac, Serbia
| | - A Djukic
- Clinical Center Kragujevac - Nuclear Medicine Department, University of Kragujevac, Faculty of Medical Sciences - Kragujevac, Serbia.,Department of Pathophysiology, Kragujevac, Serbia
| | - V Ignjatovic
- Clinical Center Kragujevac - Nuclear Medicine Department, University of Kragujevac, Faculty of Medical Sciences - Kragujevac, Serbia.,Department of Nuclear Medicine and Oncology, Kragujevac, Serbia
| | - K Vuleta
- Clinical Center Kragujevac - Nuclear Medicine Department, University of Kragujevac, Faculty of Medical Sciences - Kragujevac, Serbia
| | - S Djukic
- Department of Internal Medicine, Kragujevac, Serbia
| | | |
Collapse
|
13
|
Wang P, Jing H, Li F, Wang Z, Huo L. 99mTc-Labeled Native RBC Scintigraphy in Distinguishing Polysplenia From Abdominal Masses in a Patient With Situs Inversus Totalis. Clin Nucl Med 2019; 44:998-1000. [PMID: 31689285 DOI: 10.1097/rlu.0000000000002825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 39-year-old previously healthy woman presented possible hematuria. An ultrasound examination showed right adrenal mass and suggested pheochromocytoma. A Tc-HYNIC-TOC SPECT/CT was performed, which incidentally detected situs inversus totalis and suspicion of polysplenia without definite normal spleen in the right upper abdomen. In order to differentiate the polysplenia from other etiologies, a heat-damaged Tc RBC scintigraphy was performed. The images showed significant activity in the multiple soft tissue nodules in the posterior right abdomen, consistent with ectopic polysplenia.
Collapse
Affiliation(s)
- Peipei Wang
- From the Department of Nuclear Medicine, Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Science and PUMC; and Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing, People's Republic of China
| | | | | | | | | |
Collapse
|
14
|
Lou Y, Fan L, Hou X, Dominiczak AF, Wang JG, Staessen JA, Almustafa B, Ching S, Persu A, Bursztyn M, Cai J, Zhang H. Paroxysmal Hypertension Associated With Urination. Hypertension 2019; 74:1068-1074. [PMID: 31564165 DOI: 10.1161/hypertensionaha.119.13140] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Ying Lou
- From the Department of Hypertension, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.L., L.F., J.C., H.Z.)
| | - Luyun Fan
- From the Department of Hypertension, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.L., L.F., J.C., H.Z.)
| | - Xiaopei Hou
- Department of Geriatrics and Gerontology, Beijing Friendship Hospital, Capital Medical University, Beijing, China (X.H.)
| | - Anna F Dominiczak
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, United Kingdom (A.F.D.)
| | - Ji-Guang Wang
- Center for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluation, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China (J.-G.W.)
| | - Jan A Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S.)
- Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, The Netherlands (J.A.S.)
| | - Bader Almustafa
- Qatif Hypertension & Cardiometabolic Unit, Qatif Primary Health Care Center, Saudi Arabia (B.A.)
| | - SiewMooi Ching
- Department of Family Medicine, Faculty of Medicine and Health Science, Universiti Putra Malaysia, Selangor, Malaysia (S.M.C.)
| | - Alexandre Persu
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium (A.P.)
- Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium (A.P.)
| | - Michael Bursztyn
- Department of Medicine, Hypertension Unit, Hadassa-Hebrew University Medical Center, Mount-Scopus, Jerusalem, Isreal (M.B.)
| | - Jun Cai
- From the Department of Hypertension, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.L., L.F., J.C., H.Z.)
| | - Huimin Zhang
- From the Department of Hypertension, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.L., L.F., J.C., H.Z.)
| |
Collapse
|
15
|
Sankar G, Rajaraman V, Ganesh RN, Halanaik D, Pandit N, Ponnusamy M. Multiple Cutaneous Metastases on 99mTC-HYNIC-TOC Scan in a Rare Case of Malignant Laryngeal Paraganglioma. Indian J Nucl Med 2018; 33:348-350. [PMID: 30386061 PMCID: PMC6194765 DOI: 10.4103/ijnm.ijnm_54_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Laryngeal paraganglioma is a rare neuroendocrine tumor arising from neural crest cells of larynx, contributing to 0.6% of the laryngeal tumors. Patients usually present with compressive symptoms such as hoarseness of voice. These tumors express somatostatin receptors, which can be imaged with radioligands such as 99mTc labeled hydrazinonicotinyl-Tyr3-octreotide (HYNIC-TOC). The percentage of malignant transformation in laryngeal paraganglioma is 2%, and they usually metastasize to lymph nodes, bone, and liver. Here, we report a 99mTc HYNIC-TOC scan of a 55-year-old male patient with recurrent laryngeal paraganglioma, who presented with painful multiple metastatic cutaneous nodules.
Collapse
Affiliation(s)
- Gowri Sankar
- Department of Nuclear Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Vishnukumar Rajaraman
- Department of Nuclear Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Rajesh Nachiappa Ganesh
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Dhanapathi Halanaik
- Department of Nuclear Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Nandini Pandit
- Department of Nuclear Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Madhusudhanan Ponnusamy
- Department of Nuclear Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| |
Collapse
|
16
|
Comparison of the 68Ga-DOTATATA PET/CT, FDG PET/CT, and MIBG SPECT/CT in the Evaluation of Suspected Primary Pheochromocytomas and Paragangliomas. Clin Nucl Med 2017; 42:525-529. [DOI: 10.1097/rlu.0000000000001674] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|
17
|
Ortmeyer CP, Haufe G, Schwegmann K, Hermann S, Schäfers M, Börgel F, Wünsch B, Wagner S, Hugenberg V. Synthesis and evaluation of a [ 18F]BODIPY-labeled caspase-inhibitor. Bioorg Med Chem 2017; 25:2167-2176. [PMID: 28284866 DOI: 10.1016/j.bmc.2017.02.033] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 02/11/2017] [Accepted: 02/14/2017] [Indexed: 12/31/2022]
Abstract
BODIPYs (boron dipyrromethenes) are fluorescent dyes which show high stability and quantum yields. They feature the possibility of selective 18F-fluorination at the boron-core. Attached to a bioactive molecule and labeled with [18F]fluorine, the resulting compounds are promising tracers for multimodal imaging in vivo and can be used for PET and fluorescence imaging. A BODIPY containing a phenyl and a hydroxy substituent on boron was synthesized and characterized. Fluorinated and hydroxy substituted dyes were coupled to an isatin-based caspase inhibitor via cycloaddition and the resulting compounds were evaluated in vitro in caspase inhibition assays. The metabolic stability and the formed metabolites were investigated by incubation with mouse liver microsomes and LC-MS analysis. Subsequently the fluorophores were labeled with [18F]fluorine and an in vivo biodistribution study using dynamic PET was performed.
Collapse
Affiliation(s)
- Christian Paul Ortmeyer
- Department of Nuclear Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, D-48149 Münster, Germany; Organic Chemistry Institute, University of Münster, Corrensstr. 40, D-48149 Münster, Germany
| | - Günter Haufe
- Organic Chemistry Institute, University of Münster, Corrensstr. 40, D-48149 Münster, Germany; Cells-in-Motion Cluster of Excellence, University of Münster, Waldeyerstr. 15, D-48149 Münster, Germany.
| | - Katrin Schwegmann
- European Institute for Molecular Imaging, University of Münster, Waldeyerstr. 15, D-48149 Münster, Germany
| | - Sven Hermann
- European Institute for Molecular Imaging, University of Münster, Waldeyerstr. 15, D-48149 Münster, Germany
| | - Michael Schäfers
- Department of Nuclear Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, D-48149 Münster, Germany; Cells-in-Motion Cluster of Excellence, University of Münster, Waldeyerstr. 15, D-48149 Münster, Germany; European Institute for Molecular Imaging, University of Münster, Waldeyerstr. 15, D-48149 Münster, Germany
| | - Frederik Börgel
- Institute for Pharmaceutical and Medicinal Chemistry, University of Münster, Corrensstr. 48, D-48149 Münster, Germany
| | - Bernhard Wünsch
- Institute for Pharmaceutical and Medicinal Chemistry, University of Münster, Corrensstr. 48, D-48149 Münster, Germany
| | - Stefan Wagner
- Department of Nuclear Medicine, University Hospital Münster, Albert-Schweitzer-Campus 1, Building A1, D-48149 Münster, Germany
| | - Verena Hugenberg
- Institute for Radiology, Nuclear Medicine and Molecular Imaging, HDZ NRW, Georgstr. 11, D-32545 Bad Oeynhausen, Germany
| |
Collapse
|
18
|
Nastos K, Cheung VTF, Toumpanakis C, Navalkissoor S, Quigley AM, Caplin M, Khoo B. Peptide Receptor Radionuclide Treatment and (131)I-MIBG in the management of patients with metastatic/progressive phaeochromocytomas and paragangliomas. J Surg Oncol 2017; 115:425-434. [PMID: 28166370 DOI: 10.1002/jso.24553] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 12/11/2016] [Accepted: 12/15/2016] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVES Radionuclide therapy has been used to treat patients with progressive/metastatic paragangliomas (PGLs) and phaeochromocytomas (PCCs). The aim of the present study is to retrospectively compare the therapeutic outcomes of these modalities in patients with progressive/metastatic PCCs and PGLs. METHODS Patients with progressive/metastatic PGLs and PCCs that were subjected to radionuclide treatment in our department were retrieved from our department's database for the period 1998-2013. Overall survival (OS), progression free survival (PFS), event free survival (EFS), and response to treatment were calculated. Treatment toxicity was documented. RESULTS Twenty-two patients with progressive/metastatic PGLs or PCCs were treated with either (131)I-MIBG, (90)Y-DOTATATE or (177)Lu-DOTATATE. A total of 30 treatments were administered (16 treatments with (131)I-MIBG, 2 with (177)Lu-DOTATATE, and 12 with (90)Y-DOTATATE. Patients treated with PRRT had increased PFS and response to treatment compared to (131)I-MIBG treated patients (P < 0.05). However, difference in OS was non significant (P = 0.09). There was no difference in major toxicities between groups. When comparing only patients with PGLs, OS, PFS, EFS, and response to treatment were significantly higher in the PRRT treatment group. CONCLUSION PRRT treatment offers increased OS, PFS, EFS, and response to treatment compared to (131)I-MIBG therapy in patients with progressive/malignant PGLs.
Collapse
Affiliation(s)
- Konstantinos Nastos
- ENETS Centre of Excellence Neuroendocrine Tumour Unit, Royal Free London NHS Foundation Trust, London, UK
| | - Vincent T F Cheung
- ENETS Centre of Excellence Neuroendocrine Tumour Unit, Royal Free London NHS Foundation Trust, London, UK
| | - Christos Toumpanakis
- ENETS Centre of Excellence Neuroendocrine Tumour Unit, Royal Free London NHS Foundation Trust, London, UK
| | - Shaunak Navalkissoor
- Department of Nuclear Medicine, Royal Free London NHS Foundation Trust, London, UK
| | - Anne-Marie Quigley
- Department of Nuclear Medicine, Royal Free London NHS Foundation Trust, London, UK
| | - Martyn Caplin
- ENETS Centre of Excellence Neuroendocrine Tumour Unit, Royal Free London NHS Foundation Trust, London, UK
| | - Bernard Khoo
- ENETS Centre of Excellence Neuroendocrine Tumour Unit, Royal Free London NHS Foundation Trust, London, UK.,Department of Endocrinology, Royal Free London NHS Foundation Trust, London, UK
| |
Collapse
|
19
|
|
20
|
Qiao Z, Zhang J, Jin X, Huo L, Zhu Z, Xing H, Li F. 99mTc-HYNIC-TOC imaging in the evaluation of pancreatic masses which are potential neuroendocrine tumors. Clin Nucl Med 2015; 40:397-400. [PMID: 25706799 DOI: 10.1097/rlu.0000000000000756] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this investigation was to determine the accuracy of the findings and the diagnoses of Tc-hydrazinonicotinyl-Tyr3-octreotide scan (Tc-HYNIC-TOC imaging) in patients with pancreatic masses which were potential neuroendocrine tumors. METHODS Records of total 20 patients with pancreatic masses were retrospectively reviewed. All of the patients had been revealed by abdominal contrast CT and possibility of neuroendocrine tumors could not be excluded by CT imaging before Tc-HYNIC-TOC imaging. Tc-HYNIC-TOC imaging was performed at 1 and 4 hours post-tracer injection, and SPECT/CT images of the abdomen were also acquired. The image findings were compared to final diagnoses which were made from pathological examination. RESULTS Among all 20 pancreatic masses evaluated, there were 16 malignant lesions which included 1 ductal adenocarcinoma and 15 neuroendocrine tumors. Tc-HYNIC-TOC imaging identified 14 of 15 pancreatic neuroendocrine tumors and excluded 4 of 5 lesions which were not neuroendocrine tumors. The overall sensitivity, specificity, and accuracy was therefore 93.3% (14 of 15), 80% (4 of 5), and 90.0% (18 of 20), respectively, in our patient population. CONCLUSION Tc-HYNIC-TOC imaging provides reasonable accuracy in the evaluation pancreatic mass suspected to be neuroendocrine tumors.
Collapse
Affiliation(s)
- Zhen Qiao
- From the Peking Union Medical College Hospital Beijing, Beijing, China
| | | | | | | | | | | | | |
Collapse
|
21
|
Tan TH, Hussein Z, Saad FFA, Shuaib IL. Diagnostic Performance of (68)Ga-DOTATATE PET/CT, (18)F-FDG PET/CT and (131)I-MIBG Scintigraphy in Mapping Metastatic Pheochromocytoma and Paraganglioma. Nucl Med Mol Imaging 2015; 49:143-51. [PMID: 26085860 DOI: 10.1007/s13139-015-0331-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 02/27/2015] [Accepted: 03/02/2015] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To evaluate the diagnostic performance of (68)Ga-DOTATATE (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET)/computed tomography (CT), (18)F-FDG PET/CT and (131)I-MIBG scintigraphy in the mapping of metastatic pheochromocytoma and paraganglioma. MATERIALS AND METHODS Seventeen patients (male = 8, female = 9; age range, 13-68 years) with clinically proven or suspicious metastatic pheochromocytoma or paraganglioma were included in this prospective study. Twelve patients underwent all three modalities, whereas five patients underwent (68)Ga-DOTATATE and (131)I-MIBG without (18)F-FDG. A composite reference standard derived from anatomical and functional imaging findings, along with histopathological information, was used to validate the findings. Results were analysed on a per-patient and on per-lesion basis. Sensitivity and accuracy were assessed using McNemar's test. RESULTS On a per-patient basis, 14/17 patients were detected in (68)Ga-DOTATATE, 7/17 patients in (131)I-MIBG, and 10/12 patients in (18)F-FDG. The sensitivity and accuracy of (68)Ga-DOTATATE, (131)I-MIBG and (18)F-FDG were (93.3 %, 94.1 %), (46.7 %, 52.9 %) and (90.9 %, 91.7 %) respectively. On a per-lesion basis, an overall of 472 positive lesions were detected; of which 432/472 were identified by (68)Ga-DOTATATE, 74/472 by (131)I-MIBG, and 154/300 (patient, n = 12) by (18)F-FDG. The sensitivity and accuracy of (68)Ga-DOTATATE, (131)I-MIBG and (18)F-FDG were (91.5 %, 92.6 % p < 0.0001), (15.7 %, 26.0 % p < 0.0001) and (51.3 %, 57.8 % p < 0.0001) respectively. Discordant lesions were demonstrated on (68)Ga-DOTATATE, (131)I-MIBG and (18)F-FDG. CONCLUSIONS Ga-DOTATATE PET/CT shows high diagnostic accuracy than (131)I-MIBG scintigraphy and (18)F-FDG PET/ CT in mapping metastatic pheochromocytoma and paraganglioma.
Collapse
Affiliation(s)
- Teik Hin Tan
- Nuclear Medicine Department, National Cancer Institute, No 4, Jalan P7, Presint 7, 62550 Putrajaya, Malaysia
| | - Zanariah Hussein
- Department of Endocrine, Hospital Putrajaya, Presint 7, 62250 Putrajaya, Wilayah Persekutuan Malaysia
| | | | - Ibrahim Lutfi Shuaib
- Department of Radiology, Advanced Medical and Dental Institute, University Sains Malaysia, Bertam, 13200 Kepala Batas, Pulau Pinang Malaysia
| |
Collapse
|
22
|
Comparison of 131I-MIBG, 68Ga-DOTANOC PET/CT and 18F-FDG PET/CT scans in a patient with extra adrenal paraganglioma associated with SDH-B gene mutation. Clin Nucl Med 2015; 40:439-41. [PMID: 25742231 DOI: 10.1097/rlu.0000000000000751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Paragangliomas (PGLs) due to succinate dehydrogenase subunit B (SDH-B) mutation can be aggressive. A 40-year-old woman with normetanephrine-secreting, extra-adrenal, abdominal PGL due to SDH-B genetic mutation underwent surgical excision of primary, followed by whole-body I-MIBG scan after 6 months, which showed no abnormality. However, Ga-DOTANOC and F-FDG PET/CT scans showed primary site recurrence, hepatic and skeletal metastasis, with latter scan revealing more lesions. We suggest that F-FDG PET should be done in all patients with PGL due to SDH-B mutations, as it may show additional unsuspected lesions that may be missed by other tracers.
Collapse
|
23
|
Sister Mary Joseph Nodules on 99mTc HYNIC-TOC Scintigraphy in Patients With Neuroendocrine Tumors. Clin Nucl Med 2015; 40:166-8. [DOI: 10.1097/rlu.0000000000000563] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
24
|
Affiliation(s)
- Ji-Gang Wang
- Department of Pathology; The Affiliated Hospital of Qingdao University; Qingdao China
| | - Jing Han
- Department of Pathology; Zhongshan Hospital, Fudan University; Shanghai China
| | - Tao Jiang
- Department of Oncology; The Affiliated Hospital of Qingdao University; Qingdao China
| | - Yu-Jun Li
- Department of Pathology; The Affiliated Hospital of Qingdao University; Qingdao China
| |
Collapse
|
25
|
18F-DOPA PET/CT in the evaluation of hereditary SDH-deficiency paraganglioma-pheochromocytoma syndromes. Clin Nucl Med 2014; 39:e53-8. [PMID: 23856824 DOI: 10.1097/rlu.0b013e31829aface] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aims to evaluate the role of F-DOPA PET/CT in staging and follow-up of paraganglioma syndromes succinate dehydrogenase (SDH)-mutation-related patients, comparing F-DOPA PET/CT results with morphological imaging and biochemical results. PATIENTS AND METHODS We retrospectively studied 10 consecutive patients (3 F, 7 M, mean age 32 yrs), all with a genetically demonstrated SDH mutation (5 SDH-D, 4 SDH-B, and 1 SDH-C) and all addressed to F-DOPA PET/CT scan. Seven patients had already been operated on for one or more pheochromocytomas and/or paragangliomas and were submitted to F-DOPA PET/CT scan according to clinical, biochemical, or radiological suspicion of recurrence, while 3 were only genetically positive, with no previous symptom/sign of the disease. For all patients, biochemical analysis (plasma and/or urinary catecholamine) and results of high-resolution morphological imaging studies (CT and/or MRI) were available. Histologic/cytologic findings or imaging and biochemical follow-up were taken as gold standard in all cases. RESULTS Seven out of 10 patients showed one or more areas of pathological F-DOPA accumulation. PET/CT demonstrated the presence of the disease in 4/6 patients with no increase in catecholamine levels ("biochemically silent"). Positive detection rate was 100% in SDH-D and 40% in "non-SDHD". Analyzing per lesion, F-DOPA PET/CT demonstrated more lesions than anatomical imaging (16 vs. 7) especially in head and neck paragangliomas. CONCLUSIONS F-DOPA PET/CT seems to be the more accurate method for staging and restaging patients with SDH-mutations-related paraganglioma syndromes. F-DOPA is particularly useful in detecting head and neck and biochemically silent paragangliomas, and also in apparently healthy mutation-carrying people.
Collapse
|
26
|
(99m)Tc HYNIC-TOC imaging and 177Lu DOTA-octreotate treatment in non-iodine-concentrating dedifferentiated thyroid carcinoma metastases: an unusual alternative diagnosis. Clin Nucl Med 2014; 39:632-4. [PMID: 24873792 DOI: 10.1097/rlu.0000000000000461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The value of Tc HYNIC-TOC scintigraphy clarifying skeletal and hepatic-predominant metastatic disease in a 55-year-old woman (diagnosed earlier to have papillary carcinoma thyroid and had undergone total thyroidectomy and radioiodine ablation) is illustrated. The whole-body radioiodine scan and battery of serum tumor markers were normal. Multiple metastatic foci in the liver and skeleton were Tc HYNIC-TOC avid. Serum chromogranin A level was substantially elevated (1771.60 ng/mL). This represents an unusual alternative diagnosis signified by a highly positive scan in the setting of apparent non-iodine-concentrating metastatic disease in a patient of differentiated thyroid carcinoma.
Collapse
|
27
|
Osteomalacia-inducing renal clear cell carcinoma uncovered by 99mTc-Hydrazinonicotinyl-Tyr3-octreotide (99mTc-HYNIC-TOC) scintigraphy. Clin Nucl Med 2014; 38:922-4. [PMID: 24089059 DOI: 10.1097/rlu.0b013e3182a20ded] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Most osteomalacia-causing tumors are small, benign mesenchymal neoplasms, which are commonly located in the extremities or craniofacial regions. An 18-year-old male patient with suspicion of tumor-induced osteomalacia underwent (99m)Tc-HYNIC-TOC scintigraphy to search potential culprit tumor. The images showed a large activity in the region of the left kidney. The lesion was resected and a clear cell renal cell carcinoma was found. One year after the left nephrectomy, the patient was tumor-free without symptoms of osteomalacia.
Collapse
|
28
|
Hodin R, Lubitz C, Phitayakorn R, Stephen A. Diagnosis and management of pheochromocytoma. Curr Probl Surg 2014; 51:151-87. [DOI: 10.1067/j.cpsurg.2013.12.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Accepted: 12/27/2013] [Indexed: 12/21/2022]
|
29
|
99mTc-HYNIC-TOC (99mTc-Hydrazinonicotinyl-Tyr3-Octreotide) Scintigraphy Identifying Two Separate Causative Tumors in a Patient With Tumor-Induced Osteomalacia (TIO). Clin Nucl Med 2013; 38:664-7. [DOI: 10.1097/rlu.0b013e3182996293] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
30
|
|
31
|
Liu X, Miao Q, Zhang H, Zhang C, Cao L, Ma G, Zeng Z. Primary Cardiac Pheochromocytoma Involving Both Right and Left Atria. Ann Thorac Surg 2013; 95:337-40. [DOI: 10.1016/j.athoracsur.2012.05.084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 04/24/2012] [Accepted: 05/11/2012] [Indexed: 10/27/2022]
|
32
|
Abstract
Radiolabeled peptides targeted against receptors on the cell surface have been shown to be remarkably specific and effective in the diagnosis and therapy of malignant disease. Much of the early work in this field took place outside the United States, but in recent years the research effort within the United States has accelerated. Most of the initial studies in the United States focused on somatostatin receptor ligands. (111)In-pentetreotide was approved in 1994 and has been used extensively in the diagnosis and management of a wide variety of neuroendocrine tumors, particularly carcinoid. This work was extended to (99m)Tc-labeled analogs, and the most successful, (99m)Tc-depreotide, was approved in 1999. This agent was found to be accurate in the diagnosis of lung cancer, but it was not particularly successful because it was supplanted by (18)F-FDG imaging with positron tomography. More recently, studies with (68)Ga-labeled somatostatin analogs were initiated in the United States. This effort was delayed relative to that in other parts of the world because of difficulty in obtaining the necessary generators and regulatory uncertainty, both of which are less of a problem currently. Several ligands are being developed to image melanoma through targeting of the melanocyte-stimulating hormone receptor. Other ligands are being developed to use the arginine-glycine-aspartate oligopeptide to target angiogenesis and to use bombesin analogs to target the gastrin-releasing peptide receptor for the diagnosis and potential therapy of prostate cancer. Peptide dimers that target 2 receptors simultaneously are also being constructed, potentially increasing the selectivity of the approach significantly. Radiopeptide therapy has been explored with these ligands, initially with high-dose (111)In-pentetreotide. This step has been followed by U.S. participation in several trials with (90)Y-, (177)Lu-, and (188)Re-labeled analogs. Some of these agents are now available clinically outside the United States, and it is important to design and conduct the appropriate trials so that this therapy can be offered within the United States.
Collapse
Affiliation(s)
- Michael M Graham
- Department of Radiology, Carver College of Medicine, University of Iowa, Iowa City, Iowa 52242, USA.
| | | |
Collapse
|
33
|
Detection of recurrent pancreatic primitive neuroectodermal tumor by tc-99m hydrazinonicotinyl-tyr3-octreotide scan. Clin Nucl Med 2011; 36:54-5. [PMID: 21157213 DOI: 10.1097/rlu.0b013e3181feeffa] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 24-year-old asymptomatic female with a history of exophytic primitive neuroectodermal tumor in the uncinate process of the pancreas was evaluated by Tc-99m hydrazinonicotinyl-Tyr3-octreotide (HYNIC-TOC) imaging as a part of the routine check-up. The images revealed focally increased activity in the head of the pancreas, indicating possible recurrent tumor. However, the results of all examinations considered, especially because of negative results from anatomic imaging, the finding from the HYNIC-TOC scan was regarded as likely false positive, and no new actions were taken. Eighteen months later, the patient developed abdominal mass. Repeat HYNIC-TOC imaging redemonstrated the focus of abnormal activity, which was confirmed as recurrent primitive neuroectodermal tumor pathologically.
Collapse
|
34
|
Abstract
IMPORTANCE OF THE FIELD Tumor targeting with peptides is based on the discovery that receptors for many regulatory peptides are overexpressed in tumor cells, compared with their expression in normal tissues. Consequently, these peptides and their analogues can be used as carriers/targeting moieties for the preparation of diagnostic and therapeutic agents that have increased selectivity and decreased peripheral toxicity. AREAS COVERED IN THIS REVIEW Here an overview is given of the most relevant gonadotropin-releasing hormone (GnRH) and somatostatin derivatives, as well as of their applications in cancer diagnosis and therapy. For this purpose, recently published data in these areas (mostly articles published from 2000 to 2009) were reviewed. WHAT THE READER WILL GAIN In contrast to other regulatory peptides that stimulate the tumor growth, GnRH and somatostatin derivatives have inhibitory effect; therefore, they were used primarily for the preparation of various conjugates to be used in targeted chemotherapy, targeted radiotherapy, photodynamic therapy, boron neutron capture therapy and cancer diagnosis. Some of these conjugates have already found clinical applications, whereas others are now in preclinical and clinical trials. TAKE HOME MESSAGE Tumor targeting with hormone peptides provides a basis for the development of new diagnostic and therapeutic approaches for cancer.
Collapse
Affiliation(s)
- Gábor Mezo
- Eötvös Loránd University, Research Group of Peptide Chemistry, Hungarian Academy of Sciences, 1117 Budapest, Hungary.
| | | |
Collapse
|