Clinical value of somatostatin receptor imaging in patients with suspected head and neck paragangliomas.

Abstract

Paragangliomas or glomus tumours of the head and neck region are rare somatostatin receptor-expressing neuroendocrine tumours. Precise preoperative diagnosis is of special importance in order to adequately weigh the potential benefit of the operation against the inherent risks of the procedure. In this study, the clinical value of somatostatin receptor imaging was assessed in 19 patients who underwent somatostatin receptor scintigraphy because of known or suspected paraganglioma of the head and neck region. The results were compared with the results of computed tomography and/or magnetic resonance imaging, histology and clinical follow-up. [(111)In-DTPA- D-Phe(1)]-octreotide scintigraphy was performed 4-6 and 24 h after i.v. injection of 140-220 MBq (111)In-octreotide. Whole-body and planar images as well as single-photon emission tomography images were acquired and lesions were graded according to qualitative tracer uptake. Somatostatin receptor imaging was positive in nine patients, identifying paragangliomas for the first time in three patients and recurrent disease in six patients. In one patient, a second, previously unknown paraganglioma site was identified. Negative results were obtained in ten patients. These patients included one suffering from chronic hyperplastic otitis externa, one with granuloma tissue and an organised haematoma, one with an acoustic neuroma, one with an asymmetric internal carotid artery, two with ectasia of the bulbus venae jugularis and one with a jugular vein thrombosis. In two patients with a strong family history of paraganglioma, individual involvement could be excluded. In only one patient did somatostatin receptor imaging and magnetic resonance imaging yield false negative results in respect of recurrent paraganglioma tissue. It is concluded that somatostatin receptor scintigraphy provides important information in patients with suspected paragangliomas of the head and neck region and has a strong impact on further therapeutic management.

• Authors: Matthias Schmidt, Eva Fischer, Markus Dietlein, Olaf Michel, Kerstin Weber, Detlef Moka, Eberhard Stennert, Harald Schicha
• Journal: European journal of nuclear medicine and molecular imaging (Eur J Nucl Med Mol Imaging) Vol. 29 Issue 12 Pg. 1571-80 (Dec 2002) ISSN: 1619-7070 [Print] Germany
• PMID: 12458390 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Validation Study)

Chemical References

• Radiopharmaceuticals
• Receptors, Somatostatin
• indium-111-octreotide
• Octreotide

Topics

• Adolescent
• Adult
• Aged
• Child
• False Negative Reactions
• Female
• Follow-Up Studies
• Glomus Tumor (diagnosis, diagnostic imaging, metabolism)
• Head and Neck Neoplasms (diagnosis, diagnostic imaging, metabolism)
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Octreotide (analogs & derivatives, pharmacokinetics)
• Paraganglioma (diagnosis, diagnostic imaging, metabolism)
• Predictive Value of Tests
• Radionuclide Imaging
• Radiopharmaceuticals (pharmacokinetics)
• Receptors, Somatostatin (metabolism)
• Tomography, X-Ray Computed
• Whole-Body Counting (methods)