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Whole-Body PET/CT with 11C-Meta-Hydroxyephedrine in tumors of the sympathetic nervous system: Feasibility study and comparison with 123I-MIBG SPECT/CT

Lookup NU author(s): Professor Hermann Josef Vormoor


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The (11)C-labeled tracer meta-hydroxyephedrine ((11)C-HED) is a noradrenaline analog that was developed to visualize the sympathetic nervous system with PET. Initial clinical studies show a rapid uptake of (11)C-HED in localized tumors of this system. Whole-body imaging with (11)C-HED PET is now possible as PET/CT scanners allow a rather short examination time. The aim of this study was to evaluate the feasibility of whole-body (11)C-HED PET/CT for examination of tumors of the sympathetic nervous system and to directly compare the results with (123)I-labeled meta-iodobenzylguanidine ((123)I-MIBG) scintigraphy, including SPECT/CT. METHODS: In 19 consecutive patients, 9 mo to 68 y old (median, 32 y), 24 whole-body (11)C-HED PET/CT (low-dose CT) examinations were performed. Scans were compared with attenuation-corrected (123)I-MIBG SPECT/CT scans (24-h scan, low-dose CT). The intensity of tracer accumulation above background was visually analyzed in both scans, PET and SPECT, using a 4-value scale. In (11)C-HED PET, mean and maximum standardized uptake values were determined for all lesions. RESULTS: In 14 patients with 19 pairs of examinations, the following tumors were confirmed histologically: 6 neuroblastomas, 5 pheochromocytomas, 1 ganglioneuroblastoma, and 2 paragangliomas. In 5 patients, each having 1 pair of examinations, clinical follow-up and/or histologic examination did not reveal any tumor deriving from the sympathetic nervous system. (11)C-HED PET/CT detected 80 of 81 totally depicted tumor lesions (sensitivity, 0.99; soft tissue, 61; bone, 19). (123)I-MIBG SPECT/CT detected 75 of 81 lesions (sensitivity, 0.93; soft tissue, 56; bone, 19). With both methods, there were no false-positive lesions. The tumor-to-background contrast of (11)C-HED uptake was higher in comparison with (123)I-MIBG uptake in 26 lesions (0.32; soft tissue, 18; bone, 8), equal in 39 lesions (0.48; soft tissue, 30; bone, 9), and lower than (123)I-MIBG uptake in 16 lesions (0.20; soft tissue, 14; bone, 2). CONCLUSION: Whole-body imaging using (11)C-HED PET/CT is feasible in the clinical setting of patients with tumors of the sympathetic nervous system. (11)C-HED PET/CT detected more tumor lesions than (123)I-MIBG SPECT/CT. However, tumor-to-background contrast of (11)C-HED in lesions can be higher, equal, or lower compared with (123)I-MIBG.

Publication metadata

Author(s): Franzius C, Hermann K, Weckesser M, Kopka K, Juergens KU, Vormoor J, Schober O

Publication type: Article

Publication status: Published

Journal: Journal of Nuclear Medicine

Year: 2006

Volume: 47

Issue: 10

Pages: 1635-1642

ISSN (print): 0161-5505

ISSN (electronic): 1535-5667

Notes: 0161-5505 (Print) Journal Article