Abstract

Rationale:

Accurate diagnosis of head and neck paragangliomas is often complicated by biochemical silence and lack of catecholamine-associated symptoms, making accurate anatomical and functional imaging techniques essential to the diagnostic process.

Methods:

Ten patients (seven SDHD, three SDHB), with a total of 26 head and neck paragangliomas, were evaluated with anatomical and functional imaging. This study compares five different functional imaging techniques [18F-fluorodihydroxyphenylalanine (18F-FDOPA) positron emission tomography (PET), 18F-fluorodopamine (18F-FDA) PET/computed tomography (CT), 18F-fluoro-2-deoxy-d-glucose (18F-FDG) PET/CT, 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphy, and 111In-pentetreotide scintigraphy] in the localization of head and neck paragangliomas.

Results:

Prospectively 18F-FDOPA PET localized 26 of 26 lesions in the 10 patients, CT/magnetic resonance imaging localized 21 of 26 lesions, 18F-FDG PET/CT localized 20 of 26 lesions, 111In-pentetreotide scintigraphy localized 16 of 25 lesions, 18F-FDA PET/CT localized 12 of 26 lesions, and 123I-MIBG scintigraphy localized eight of 26 lesions. Differences in imaging efficacy related to genetic phenotype, even in the present small sample size, included the negativity of 18F-FDA PET/CT and 123I-MIBG scintigraphy in patients with SDHB mutations and the accuracy of 18F-FDG PET/CT in all patients with SDHD mutations, as compared with the accuracy of 18F-FDG PET/CT in only one patient with an SDHB mutation.

Conclusion:

Overall, 18F-FDOPA PET proved to be the most efficacious functional imaging modality in the localization of SDHx-related head and neck paragangliomas and may be a potential first-line functional imaging agent for the localization of these tumors.

You do not currently have access to this article.