gallium-ga-68-dotatate and Head-and-Neck-Neoplasms

This article discusses the application of fludeoxyglucose PET/computed tomography (CT) technology in head and neck cancer diagnosis and management, as well as advantages and disadvantages relative to traditional imaging modalities. A successful scan relies on precise patient preparation, and compliance to specific protocols before and during the scan. Finally, this article briefly introduces a PET/CT scan recently approved by the Food and Drug Administration for neuroendocrine tumors.

Topics: Fluorodeoxyglucose F18; Head and Neck Neoplasms; Humans; Neuroendocrine Tumors; Organometallic Compounds; Positron Emission Tomography Computed Tomography; Radioactive Tracers; Radiopharmaceuticals; Sensitivity and Specificity; Tomography, X-Ray Computed

Somatostatin receptor (SSTR) imaging with 68Ga-labeled somatostatin analogs has been used for many tumors with high SSTR expression. Increased uptake mostly depends on the SSTR status of tumors; however, false-positive uptake can be demonstrated in benign diseases or other malignancies because of the increased SSTR expression. We present a case of a 50-year-old man with increased SSTR activity on cervical lesion located in internal jugular chain in 68Ga-DOTATATE PET/CT, which was performed for suspicion of paraganglioma. Biopsy revealed lymph node metastasis of squamous cell carcinoma other than paraganglioma. 18F-FDG PET/CT showed primary malignancy on larynx and lymph node metastasis, which were correlated surgically.

Topics: Biopsy; Carcinoma, Squamous Cell; Diagnosis, Differential; Head and Neck Neoplasms; Humans; Lymphatic Metastasis; Male; Middle Aged; Organometallic Compounds; Paraganglioma; Positron Emission Tomography Computed Tomography

Pheochromocytomas/paragangliomas overexpress somatostatin receptors, and recent studies have already shown excellent results in the localization of sympathetic succinate dehydrogenase complex, subunit B, mutation-related metastatic pheochromocytomas/paragangliomas using (68)Ga-DOTATATE PET/CT. Therefore, the goal of our study was to assess the clinical utility of this functional imaging modality in parasympathetic head and neck paragangliomas (HNPGLs) compared with anatomic imaging with CT/MRI and other functional imaging modalities, including (18)F-fluorohydroyphenylalanine ((18)F-FDOPA) PET/CT, currently the gold standard in the functional imaging of HNPGLs.. (68)Ga-DOTATATE PET/CT was prospectively performed in 20 patients with HNPGLs. All patients also underwent (18)F-FDOPA PET/CT, (18)F-FDG PET/CT, and CT/MRI, with 18 patients also undergoing (18)F-fluorodopamine ((18)F-FDA) PET/CT. (18)F-FDOPA PET/CT and CT/MRI served as the imaging comparators.. Thirty-eight lesions in 20 patients were detected, with (18)F-FDOPA PET/CT identifying 37 of 38 and CT/MRI identifying 23 of 38 lesions (P < 0.01). All 38 and an additional 7 lesions (P = 0.016) were detected on (68)Ga-DOTATATE PET/CT. Significantly fewer lesions were identified by (18)F-FDG PET/CT (24/38, P < 0.01) and (18)F-FDA PET/CT (10/34, P < 0.01).. (68)Ga-DOTATATE PET/CT identified more lesions than other imaging modalities. With the results of the present study, and the increasing availability and use of DOTA analogs in the therapy of neuroendocrine tumors, we expect that (68)Ga-DOTATATE PET/CT will become the preferred functional imaging modality for HNPGLs in the near future.

Topics: Adult; Aged; Dihydroxyphenylalanine; Female; Fluorodeoxyglucose F18; Head and Neck Neoplasms; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Multimodal Imaging; Organometallic Compounds; Paraganglioma; Positron-Emission Tomography; Prospective Studies; Radiopharmaceuticals; Succinate Dehydrogenase; Tomography, X-Ray Computed

Topics: Abdominal Neoplasms; Carcinoma, Squamous Cell; Diagnosis, Differential; Fluorodeoxyglucose F18; Head and Neck Neoplasms; Humans; Male; Middle Aged; Nasopharyngeal Neoplasms; Neoplasms, Multiple Primary; Organometallic Compounds; Paraganglioma; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals; Squamous Cell Carcinoma of Head and Neck; Tissue Distribution

Topics: Adult; Female; Head and Neck Neoplasms; Humans; Organometallic Compounds; Paraganglioma; Positron-Emission Tomography; Tomography, X-Ray Computed