Background: Large-scale data on the diagnostic performance of functional imaging in metastatic pheochromocytoma/paraganglioma (PPGL) are scarce.Objective: To analyze the diagnostic accuracy of functional imaging for the assessment of metastases during long-term follow-up (FU).Design: Retrospective cohort study, 1991–2025.Setting: Referral center.Outcomes: Sensitivity and specificity of123MIBG-,18F-DOPA-,68GaDOTA-based and18FDG PET/CT.Patients:Patients with metastatic PPGL and without PPGL, ≥1 functional imaging prior to first diagnosis and/or during FU and FU ≥ 3 months.Results: 59123MIBG-, 10118F-DOPA-, 1118FDG- and 7468GaDOTA-based PET/CT were performed in 57 patients with metastatic PPGL and 37123MIBG-, 32318F-DOPA-, 25918FDG- and 64168GaDOTA-based imaging in 527 patients without PPGL. FU was 11.6 ± 11.4 and 5.1 ± 4.7 years, respectively. Sensitivity for the detection of all metastases (total cohort) by patient-based analysis was comparable between18F-DOPA (77%), both68GaDOTA-based tracers combined (67%) and123MIBG (72%); lesion-based analysis was better for18F-DOPA (94%) than for68GaDOTA (85%) and123MIBG (67%). Specificity (patient- and lesion-based) of18F-DOPA vs.68GaDOTA (96–99%) was comparable and better than123MIBG (73%) and18FDG (75%).Conclusions: Sensitivity of18F-DOPA was superior to68GaDOTA for the detection of all and bone metastases in the total cohort and in patients with PCC, that of68GaDOTA was better for bone metastases with PGL, specificity was comparable and for both was better than for18FDG and123MIBG. Given the beneficial pharmaceutical properties and favorable diagnostic performance,18F-DOPA may be a good alternative to68GaDOTA-based tracers for the functional imaging of metastatic PPGL.
背景：关于功能性影像学在转移性嗜铬细胞瘤/副神经节瘤（PPGL）诊断效能的大规模数据较为缺乏。 目的：分析长期随访期间功能性影像学评估转移灶的诊断准确性。 设计：回顾性队列研究，1991–2025年。 机构：转诊中心。 观察指标：¹²³I-MIBG、¹⁸F-DOPA、⁶⁸Ga-DOTA类及¹⁸F-FDG PET/CT的敏感性与特异性。 患者：纳入转移性PPGL患者及非PPGL患者，要求在首次诊断前和/或随访期间至少接受一次功能性影像学检查，且随访时间≥3个月。 结果：57例转移性PPGL患者共接受59次¹²³I-MIBG、101次¹⁸F-DOPA、11次¹⁸F-FDG及74次⁶⁸Ga-DOTA类PET/CT检查；527例非PPGL患者共接受371次¹²³I-MIBG、323次¹⁸F-DOPA、259次¹⁸F-FDG及641次⁶⁸Ga-DOTA类影像学检查。两组平均随访时间分别为11.6±11.4年与5.1±4.7年。基于患者分析显示，¹⁸F-DOPA（77%）、两种⁶⁸Ga-DOTA类示踪剂联合（67%）与¹²³I-MIBG（72%）对全部转移灶（总体队列）的检测敏感性相当；基于病灶分析中，¹⁸F-DOPA（94%）优于⁶⁸Ga-DOTA（85%）和¹²³I-MIBG（67%）。¹⁸F-DOPA与⁶⁸Ga-DOTA的特异性（基于患者及病灶分析）相当（96–99%），且均优于¹²³I-MIBG（73%）和¹⁸F-FDG（75%）。 结论：在总体队列及嗜铬细胞瘤患者中，¹⁸F-DOPA对全部转移灶及骨转移的检测敏感性优于⁶⁸Ga-DOTA；而在副神经节瘤骨转移中，⁶⁸Ga-DOTA敏感性更佳。两者特异性相当，且均优于¹⁸F-FDG与¹²³I-MIBG。鉴于¹⁸F-DOPA良好的药物特性与诊断效能，其可作为⁶⁸Ga-DOTA类示踪剂在转移性PPGL功能性影像学检查中的有效替代方案。
肿瘤(癌症)患者之家