PET/CT provides superior lesion detection for head and neck paragangliomas compared to gold standard MRI

Toronto, Ontario—A novel imaging approach—⁶⁸Ga-DOTATATE PET/CT—can more accurately differentiate residual/recurrent tumors from post-surgery scar tissue in patients with head and neck paragangliomas (HNPGLs) compared to MRI. Providing functional information about the tumors, ⁶⁸Ga-DOTATATE PET/CT has the potential to play a vital role in improving preoperative and postoperative treatment planning strategies for HNPGL patients. This research was presented at the 2024 Society of Nuclear Medicine and Molecular Imaging Annual Meeting.

HNPGLs are rare neuroendocrine tumors that pose diagnostic and therapeutic challenges due to their complex anatomical locations. The role of imaging modalities is crucial in the management of these tumors. While MRI is the gold standard for preoperative evaluation and postoperative surveillance, its ability to differentiate residual tumor from postoperative changes, such as scar tissue, is limited.

“We know that HNPGLs typically express somatostatin receptors (SSTRs) on the surface of neuroendocrine cells,” said Patrick Wojtylak, MSHA, CNMT, Radiology System Manager for Nuclear Medicine at University Hospital Cleveland Medical Center in Cleveland, Ohio. “Since ⁶⁸Ga-DOTATATE has a high sensitivity and specificity for SSTR, we sought to determine whether ⁶⁸Ga-DOTATATE PET/CT could detect HNPGLs more accurately than MRI, specifically post-surgery.”

The study included 25 patients with preoperative clinical suspicion of HNPGLs (five patients) or postoperative pathology-proven HNPGLs (20 patients). Patients underwent ⁶⁸Ga-DOTATATE PET/CT and MRI scans. All studies were then reviewed by a specialized nuclear medicine physician experienced in ⁶⁸Ga-DOTATATE PET/CT interpretation.

Compared to contrast-enhanced MRI alone, ⁶⁸Ga-DOTATATE PET/CT offered superior lesion detection and more accurate delineation of tumor extent in patients with HNPGLs. It also provided improved differentiation between recurrent or residual tumor and scar tissue post-surgery, exhibiting heightened sensitivity and specificity compared to MRI alone.

“⁶⁸Ga-DOTATATE PET/CT holds promise as a reliable imaging biomarker for HNPGLs, offering enhanced sensitivity and specificity compared to conventional imaging modalities,” noted Wojtylak. “Integrating ⁶⁸Ga-DOTATATE PET/CT into the clinical management of HNPGLs can lead to more accurate diagnosis, better treatment planning, and improved patient outcomes.”

Abstract 241126. “Utilization of Gallium-68 Dotatate PET CT for the Evaluation of Head and Neck Paraganliomas in a Major Tertiary Academic University Neurosurgical Center,” Patrick Wojtylak, Sarah Ash, Robert Jones, Prashant Vempati, Qiubai Li, University Hospital Cleveland Medical Center, Cleveland, Ohio.

Link to Session

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All 2024 SNMMI Annual Meeting abstracts can be found online.

About the Society of Nuclear Medicine and Molecular Imaging

The Society of Nuclear Medicine and Molecular Imaging (SNMMI) is an international scientific and medical organization dedicated to advancing nuclear medicine and molecular imaging—vital elements of precision medicine that allow diagnosis and treatment to be tailored to individual patients in order to achieve the best possible outcomes.

SNMMI’s members set the standard for molecular imaging and nuclear medicine practice by creating guidelines, sharing information through journals and meetings and leading advocacy on key issues that affect molecular imaging and therapy research and practice. For more information, visit www.snmmi.org.

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