68ga-dotanoc and Bone-Neoplasms

Topics: Acetabulum; Bone Neoplasms; Female; Humans; Mutation; Neck; Neoplasm Staging; Organometallic Compounds; Paraganglioma; Positron-Emission Tomography; Radiopharmaceuticals; Succinate Dehydrogenase; Tomography, X-Ray Computed

Pheochromocytomas are rare tumors which can be malignant in 10% of cases. We present the case of a 75-year-old woman who presented with headache and palpitation for 1 year. She had a past history of right adrenalectomy for pheochromocytoma 20 years back. In between, the patient was asymptomatic. Twenty-four-hour urinary vanillylmandelic acid was raised. Noncontrast CT and ultrasound of abdomen were unremarkable. The patient underwent 68Ga-DOTANOC PET/CT that showed metastasis to left ilium, which was confirmed on biopsy.

Topics: Adrenal Gland Neoplasms; Aged; Bone Neoplasms; Female; Humans; Multimodal Imaging; Organometallic Compounds; Pheochromocytoma; Positron-Emission Tomography; Recurrence; Tomography, X-Ray Computed

A patient with a history of radical thyroidectomy for medullary thyroid carcinoma (MTC) was studied by 68Ga [DOTA,1-Nal3]octreotide PET/CT for suspected relapse. PET/CT documented a focal area of somatostatin receptors expression at bone level. Although 68Ga DOTA-peptides PET has been successfully used for the detection of neuroendocrine tumors, its role in MTC patients is still under evaluation. In fact, although deriving from the neural crest, MTC cells may show a variable expression of somatostatin receptors. This case shows that PET/CT with DOTANOC may be a useful complementary imaging modality in patients with well-differentiated MTC.

Topics: Bone Neoplasms; Carcinoma, Neuroendocrine; Female; Humans; Middle Aged; Multimodal Imaging; Organometallic Compounds; Positron-Emission Tomography; Recurrence; Thyroid Neoplasms; Tomography, X-Ray Computed

To retrospectively evaluate the sensitivity, specificity and accuracy of (68)Ga-DOTA-NOC PET/CT and CT alone for the evaluation of bone metastasis in patients with neuroendocrine tumour (NET).. From among patients with NET who underwent (68)Ga-DOTA-NOC PET/CT between April 2006 and November 2008 in our centre, 223 were included in the study. Criteria for inclusion were pathological confirmation of NET and a follow-up period of at least 10 months. PET and CT images were retrospectively reviewed by two nuclear medicine specialists and two radiologists, respectively, without knowledge of the patient history or the findings of other imaging modalities. PET data were compared with the CT findings. Interobserver agreement was evaluated in terms of the kappa score. Clinical and imaging follow-up were used as the standard of reference to evaluate the PET findings.. PET was performed for staging (49/223), unknown primary tumour detection (24/223), restaging (32/223), restaging before radioimmunotherapy (1/223), evaluation during therapy (12/223), equivocal findings on conventional imaging (4/223 at the bone level; 61/223 at sites other than bone), and follow-up (40/223). A very high interobserver agreement was observed. CT detected at least one bone lesion in only 35 of 44 patients with a positive PET scan. In particular, PET showed more lesions in 20/35 patients, a lower number of lesions in 8/35, and the same number in 7/35. The characteristics of the lesions (sclerotic, lytic, mixed) on the basis of the CT report did not influence PET reading. PET revealed the presence of at least one bone metastasis in nine patients with a negative CT scan. Considering patients with a negative PET scan (179), CT showed equivocal findings at the bone level in three (single small sclerotic abnormality in two at the spine level, and bilateral small sclerotic abnormalities in the humeri, femurs and scapula). Clinical follow-up confirmed the PET findings in all patients; thus there were no false-positive or false-negative findings. Considering all patients, PET detected more lesions than CT (246 vs. 194). As compared to CT, on a patient basis PET showed a higher sensitivity (100% vs. 80%), specificity (100% vs. 98%), positive predictive value (100% vs. 92%), and negative predictive value (100% vs. 95%).. In conclusion, (68)Ga DOTA-NOC PET was more accurate than CT for the identification of bone lesions and led to a change in clinical management in nine patients with a negative CT scan.

Topics: Adult; Aged; Aged, 80 and over; Bone Neoplasms; Female; Gallium Radioisotopes; Humans; Male; Middle Aged; Neuroendocrine Tumors; Observer Variation; Organometallic Compounds; Patient Care Planning; Pelvic Bones; Positron-Emission Tomography; Predictive Value of Tests; Radiopharmaceuticals; Retrospective Studies; Ribs; Sensitivity and Specificity; Spinal Neoplasms; Tomography, X-Ray Computed