FDG PET-CT imaging in head and neck paragangliomas: A centre experience

TY - JOUR

T1 - FDG PET-CT imaging in head and neck paragangliomas

T2 - A centre experience

AU - Boughdad, Sarah

AU - O'Connor, Ann

AU - Cook, Gary

AU - Pike, Lucy

AU - Connor, Steve

AU - Obholzer, Rupert

AU - Warbey, Victoria

N1 - Funding Information: The authors acknowledge financial support from the King's College London/University College London Comprehensive Cancer Imaging Centres funded by Cancer Research UK and Engineering and Physical Sciences Research Council in association Swith the Medical Research Council and the Department of Health (C1519/A16463) and the Wellcome Trust EPSRC Center for Medical Engineering at King’s College LondonS (WT203148/Z/16/Z). Funding Information: The authors acknowledge financial support from the King's College London/University College London Comprehensive Cancer Imaging Centres funded by Cancer Research UK and Engineering and Physical Sciences Research Council in association Swith the Medical Research Council and the Department of Health (C1519/A16463) and the Wellcome Trust EPSRC Center for Medical Engineering at King?s College LondonS (WT203148/Z/16/Z). Publisher Copyright: © 2021 John Wiley & Sons Ltd.

PY - 2021/8

Y1 - 2021/8

N2 - Head and neck paragangliomas (HNPGLs) are rare tumours with ~ 30% genetic mutations, mainly in succinate dehydrogenase (SDHx) genes. The utility of FDG PET-CT in HNPGLs is questioned by recent developments in novel radiotracers. We therefore performed a retrospective study in a single tertiary referral centre to address the utility of FDG PET/CT in HNPGLs.MethodsClinical data on genetic testing and follow-up were collected for patients who had FDG PET-CT scans from 2004 to 2016. Receiver operator characteristic (ROC) analysis was used to compare standardized uptake values (SUVs), metabolic tumour volume (MTV) and total lesion glycolysis (TLG) between lesions in patients who had a clinically related event: event (+) and those who did not: event (−). Similarly, we compared PET parameters between SDHx+ patients and a control group with low probability of mutation.ResultsOf 153 HNPGL patients, 73 (29 SDHx+) with 93 FDG-positive lesions were identified: 53.8% of lesions were assessed in a pre-therapeutic setting. In comparison with a reference extracted from clinicoradiological database, FDG PET-CT showed good performance to detect HNPGLs (96.6% accuracy). In this study population, 16 disease progression, 1 recurrence and 1 death were recorded and event (+) patients had lesions with higher SUVmax (p = .03 and p = .02, respectively). Conversely, there were no differences in PET parameters between lesions in SDHx+ patients and controls with low probability of SDHx+ mutations.ConclusionsFDG PET-CT has clinical utility in HNPGLs, mostly before local treatment. There were no significant differences in PET parameters between SDHx patients and a sporadic HNPGL population. However, regardless of SDHx mutation status, a high SUVmax was associated with more clinical events and prompts to a closer follow-up.

AB - Head and neck paragangliomas (HNPGLs) are rare tumours with ~ 30% genetic mutations, mainly in succinate dehydrogenase (SDHx) genes. The utility of FDG PET-CT in HNPGLs is questioned by recent developments in novel radiotracers. We therefore performed a retrospective study in a single tertiary referral centre to address the utility of FDG PET/CT in HNPGLs.MethodsClinical data on genetic testing and follow-up were collected for patients who had FDG PET-CT scans from 2004 to 2016. Receiver operator characteristic (ROC) analysis was used to compare standardized uptake values (SUVs), metabolic tumour volume (MTV) and total lesion glycolysis (TLG) between lesions in patients who had a clinically related event: event (+) and those who did not: event (−). Similarly, we compared PET parameters between SDHx+ patients and a control group with low probability of mutation.ResultsOf 153 HNPGL patients, 73 (29 SDHx+) with 93 FDG-positive lesions were identified: 53.8% of lesions were assessed in a pre-therapeutic setting. In comparison with a reference extracted from clinicoradiological database, FDG PET-CT showed good performance to detect HNPGLs (96.6% accuracy). In this study population, 16 disease progression, 1 recurrence and 1 death were recorded and event (+) patients had lesions with higher SUVmax (p = .03 and p = .02, respectively). Conversely, there were no differences in PET parameters between lesions in SDHx+ patients and controls with low probability of SDHx+ mutations.ConclusionsFDG PET-CT has clinical utility in HNPGLs, mostly before local treatment. There were no significant differences in PET parameters between SDHx patients and a sporadic HNPGL population. However, regardless of SDHx mutation status, a high SUVmax was associated with more clinical events and prompts to a closer follow-up.

UR - http://www.scopus.com/inward/record.url?scp=85106969365&partnerID=8YFLogxK

U2 - 10.1111/cen.14446

DO - 10.1111/cen.14446

M3 - Article

SN - 0300-0664

VL - 95

SP - 315

EP - 322

JO - Clinical endocrinology

JF - Clinical endocrinology

IS - 2

ER -