Added Value of SPECT/CT for Correlation of MIBG Scintigraphy and Diagnostic CT in Neuroblastoma and Pheochromocytoma
In pheochromocytoma and neuroblastoma, pathologic findings on metaiodobenzylguanidine (MIBG) scintigraphy (planar and SPECT) and on diagnostic CT are sometimes difficult to correlate. Furthermore, CT reading may be impaired by anatomic distortion after surgery or irradiation and if contrast agent is...
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| Veröffentlicht in: | American journal of roentgenology (1976) 2008-04, Vol.190 (4), p.1085-1090 |
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| creator | Rozovsky, Katia Koplewitz, Benjamin Z Krausz, Yodphat Revel-Vilk, Shoshana Weintraub, Michael Chisin, Roland Klein, Martine |
| description | In pheochromocytoma and neuroblastoma, pathologic findings on metaiodobenzylguanidine (MIBG) scintigraphy (planar and SPECT) and on diagnostic CT are sometimes difficult to correlate. Furthermore, CT reading may be impaired by anatomic distortion after surgery or irradiation and if contrast agent is not injected. The present study evaluates the impact of SPECT/CT fusion images on correlation and image analysis of both techniques.
Eleven patients, three adults (age range, 27-64 years) with pheochromocytoma and eight children (age range, 16-72 months) with neuroblastoma, underwent 15 (123)I-MIBG scintigraphy (whole body and SPECT/CT) and diagnostic CT during follow-up after treatment, with a time interval of 2 to 30 days (mean, 12 days) between MIBG scintigraphy and diagnostic CT. The diagnostic CT scans were read twice: blindly and with knowledge of the SPECT/CT findings. The scintigraphic and anatomic data were subsequently compared and were verified by clinical outcome.
Of 15 imaging studies, there were nine cases of discordance between SPECT/CT and diagnostic CT, whereas concordant findings of planar MIBG and diagnostic CT were observed in six studies. Overall, SPECT/CT provided additional information in eight of the 15 cases (53%) and in eight of nine discordant studies (89%). In one case of pheochromocytoma in which anatomy was distorted by previous surgery and contrast agent was not injected, SPECT/CT findings guided the diagnostic CT that had initially misinterpreted the right adrenal gland as the inferior vena cava. In three of 11 studies performed for neuroblastoma, SPECT/CT facilitated the diagnostic CT reading: in one study, a small paravertebral thickening was overlooked at blind CT reading and in another case, SPECT/CT localized and characterized a soft-tissue mass medial to the iliac bone, which was missed on diagnostic CT in an area of difficult differential anatomy (bowel loops and eventual involved lymph nodes). In the third case, SPECT/CT directed the diagnostic CT to the MIBG abnormality after multiple surgical procedures. In these four cases, MIBG SPECT/CT allowed for localization of the pathologic site that was difficult to visualize on diagnostic CT. In four additional neuroblastoma studies in which a residual mass was present on diagnostic CT, planar MIBG scintigraphy was negative. SPECT/CT, focused on the area of the diagnostic CT abnormality, showed no focal MIBG uptake, thus increasing the diagnostic certainty of remission.
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| doi_str_mv | 10.2214/AJR.07.2107 |
| format | Article |
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Eleven patients, three adults (age range, 27-64 years) with pheochromocytoma and eight children (age range, 16-72 months) with neuroblastoma, underwent 15 (123)I-MIBG scintigraphy (whole body and SPECT/CT) and diagnostic CT during follow-up after treatment, with a time interval of 2 to 30 days (mean, 12 days) between MIBG scintigraphy and diagnostic CT. The diagnostic CT scans were read twice: blindly and with knowledge of the SPECT/CT findings. The scintigraphic and anatomic data were subsequently compared and were verified by clinical outcome.
Of 15 imaging studies, there were nine cases of discordance between SPECT/CT and diagnostic CT, whereas concordant findings of planar MIBG and diagnostic CT were observed in six studies. Overall, SPECT/CT provided additional information in eight of the 15 cases (53%) and in eight of nine discordant studies (89%). In one case of pheochromocytoma in which anatomy was distorted by previous surgery and contrast agent was not injected, SPECT/CT findings guided the diagnostic CT that had initially misinterpreted the right adrenal gland as the inferior vena cava. In three of 11 studies performed for neuroblastoma, SPECT/CT facilitated the diagnostic CT reading: in one study, a small paravertebral thickening was overlooked at blind CT reading and in another case, SPECT/CT localized and characterized a soft-tissue mass medial to the iliac bone, which was missed on diagnostic CT in an area of difficult differential anatomy (bowel loops and eventual involved lymph nodes). In the third case, SPECT/CT directed the diagnostic CT to the MIBG abnormality after multiple surgical procedures. In these four cases, MIBG SPECT/CT allowed for localization of the pathologic site that was difficult to visualize on diagnostic CT. In four additional neuroblastoma studies in which a residual mass was present on diagnostic CT, planar MIBG scintigraphy was negative. SPECT/CT, focused on the area of the diagnostic CT abnormality, showed no focal MIBG uptake, thus increasing the diagnostic certainty of remission.
In cases of equivocal diagnostic CT, SPECT/CT bridges the gap between MIBG scintigraphy and diagnostic CT, with guidance of the diagnostic CT and characterization of its findings. In this small series, MIBG SPECT/CT increased the diagnostic certainty in 89% of discordant studies.</description><identifier>ISSN: 0361-803X</identifier><identifier>EISSN: 1546-3141</identifier><identifier>DOI: 10.2214/AJR.07.2107</identifier><identifier>PMID: 18356459</identifier><identifier>CODEN: AAJRDX</identifier><language>eng</language><publisher>Leesburg, VA: Am Roentgen Ray Soc</publisher><subject>3-Iodobenzylguanidine ; Adrenal Gland Neoplasms - diagnostic imaging ; Adrenals. Adrenal axis. Renin-angiotensin system (diseases) ; Adult ; Biological and medical sciences ; Child ; Child, Preschool ; Endocrinopathies ; Female ; Humans ; Infant ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Middle Aged ; Neuroblastoma - diagnostic imaging ; Neurology ; Non tumoral diseases. Target tissue resistance. Benign neoplasms ; Pheochromocytoma - diagnostic imaging ; Radiopharmaceuticals ; Tomography, Emission-Computed, Single-Photon ; Tomography, X-Ray Computed ; Tumors of the nervous system. Phacomatoses</subject><ispartof>American journal of roentgenology (1976), 2008-04, Vol.190 (4), p.1085-1090</ispartof><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c415t-b5530f3aaa37432af29f4741cc993719ba95e675e6d891d8883e52db8ee0f4bf3</citedby><cites>FETCH-LOGICAL-c415t-b5530f3aaa37432af29f4741cc993719ba95e675e6d891d8883e52db8ee0f4bf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4120,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20194192$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18356459$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rozovsky, Katia</creatorcontrib><creatorcontrib>Koplewitz, Benjamin Z</creatorcontrib><creatorcontrib>Krausz, Yodphat</creatorcontrib><creatorcontrib>Revel-Vilk, Shoshana</creatorcontrib><creatorcontrib>Weintraub, Michael</creatorcontrib><creatorcontrib>Chisin, Roland</creatorcontrib><creatorcontrib>Klein, Martine</creatorcontrib><title>Added Value of SPECT/CT for Correlation of MIBG Scintigraphy and Diagnostic CT in Neuroblastoma and Pheochromocytoma</title><title>American journal of roentgenology (1976)</title><addtitle>AJR Am J Roentgenol</addtitle><description>In pheochromocytoma and neuroblastoma, pathologic findings on metaiodobenzylguanidine (MIBG) scintigraphy (planar and SPECT) and on diagnostic CT are sometimes difficult to correlate. Furthermore, CT reading may be impaired by anatomic distortion after surgery or irradiation and if contrast agent is not injected. The present study evaluates the impact of SPECT/CT fusion images on correlation and image analysis of both techniques.
Eleven patients, three adults (age range, 27-64 years) with pheochromocytoma and eight children (age range, 16-72 months) with neuroblastoma, underwent 15 (123)I-MIBG scintigraphy (whole body and SPECT/CT) and diagnostic CT during follow-up after treatment, with a time interval of 2 to 30 days (mean, 12 days) between MIBG scintigraphy and diagnostic CT. The diagnostic CT scans were read twice: blindly and with knowledge of the SPECT/CT findings. The scintigraphic and anatomic data were subsequently compared and were verified by clinical outcome.
Of 15 imaging studies, there were nine cases of discordance between SPECT/CT and diagnostic CT, whereas concordant findings of planar MIBG and diagnostic CT were observed in six studies. Overall, SPECT/CT provided additional information in eight of the 15 cases (53%) and in eight of nine discordant studies (89%). In one case of pheochromocytoma in which anatomy was distorted by previous surgery and contrast agent was not injected, SPECT/CT findings guided the diagnostic CT that had initially misinterpreted the right adrenal gland as the inferior vena cava. In three of 11 studies performed for neuroblastoma, SPECT/CT facilitated the diagnostic CT reading: in one study, a small paravertebral thickening was overlooked at blind CT reading and in another case, SPECT/CT localized and characterized a soft-tissue mass medial to the iliac bone, which was missed on diagnostic CT in an area of difficult differential anatomy (bowel loops and eventual involved lymph nodes). In the third case, SPECT/CT directed the diagnostic CT to the MIBG abnormality after multiple surgical procedures. In these four cases, MIBG SPECT/CT allowed for localization of the pathologic site that was difficult to visualize on diagnostic CT. In four additional neuroblastoma studies in which a residual mass was present on diagnostic CT, planar MIBG scintigraphy was negative. SPECT/CT, focused on the area of the diagnostic CT abnormality, showed no focal MIBG uptake, thus increasing the diagnostic certainty of remission.
In cases of equivocal diagnostic CT, SPECT/CT bridges the gap between MIBG scintigraphy and diagnostic CT, with guidance of the diagnostic CT and characterization of its findings. In this small series, MIBG SPECT/CT increased the diagnostic certainty in 89% of discordant studies.</description><subject>3-Iodobenzylguanidine</subject><subject>Adrenal Gland Neoplasms - diagnostic imaging</subject><subject>Adrenals. Adrenal axis. Renin-angiotensin system (diseases)</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Endocrinopathies</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neuroblastoma - diagnostic imaging</subject><subject>Neurology</subject><subject>Non tumoral diseases. Target tissue resistance. Benign neoplasms</subject><subject>Pheochromocytoma - diagnostic imaging</subject><subject>Radiopharmaceuticals</subject><subject>Tomography, Emission-Computed, Single-Photon</subject><subject>Tomography, X-Ray Computed</subject><subject>Tumors of the nervous system. Phacomatoses</subject><issn>0361-803X</issn><issn>1546-3141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpF0MFv0zAUBnALgVg3OHFHvgAHlM6OncQ-dmEbQwMmVhA368WxG6MkLnaiqv89Lq3gYFmyf-_T04fQK0qWeU755erTtyWpljkl1RO0oAUvM0Y5fYoWhJU0E4T9PEPnMf4ihFRCVs_RGRWsKHkhF2hata1p8Q_oZ4O9xY8P1_X6sl5j6wOufQimh8n58fD3-e7qFj9qN05uE2Db7TGMLf7gYDP6ODmN05gb8RczB9_0ECc_wF_y0Bmvu-AHr_eHxxfomYU-mpen-wJ9v7le1x-z-6-3d_XqPtOcFlPWFAUjlgEAqzjLwebS8opTraVkFZUNyMKUVTqtkLQVQjBT5G0jjCGWN5ZdoLfH3G3wv2cTJzW4qE3fw2j8HFUpiOSlKBN8f4Q6-BiDsWob3ABhryhRh5JVKlmRSh1KTvr1KXZuBtP-t6dWE3hzAhA19DbAqF3853JCJacyT-7d0XVu0-1cMCoO0PcplqrdbkclUTxtIAr2B-1jkRc</recordid><startdate>20080401</startdate><enddate>20080401</enddate><creator>Rozovsky, Katia</creator><creator>Koplewitz, Benjamin Z</creator><creator>Krausz, Yodphat</creator><creator>Revel-Vilk, Shoshana</creator><creator>Weintraub, Michael</creator><creator>Chisin, Roland</creator><creator>Klein, Martine</creator><general>Am Roentgen Ray Soc</general><general>American Roentgen Ray Society</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20080401</creationdate><title>Added Value of SPECT/CT for Correlation of MIBG Scintigraphy and Diagnostic CT in Neuroblastoma and Pheochromocytoma</title><author>Rozovsky, Katia ; Koplewitz, Benjamin Z ; Krausz, Yodphat ; Revel-Vilk, Shoshana ; Weintraub, Michael ; Chisin, Roland ; Klein, Martine</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c415t-b5530f3aaa37432af29f4741cc993719ba95e675e6d891d8883e52db8ee0f4bf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>3-Iodobenzylguanidine</topic><topic>Adrenal Gland Neoplasms - diagnostic imaging</topic><topic>Adrenals. Adrenal axis. Renin-angiotensin system (diseases)</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Endocrinopathies</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neuroblastoma - diagnostic imaging</topic><topic>Neurology</topic><topic>Non tumoral diseases. Target tissue resistance. Benign neoplasms</topic><topic>Pheochromocytoma - diagnostic imaging</topic><topic>Radiopharmaceuticals</topic><topic>Tomography, Emission-Computed, Single-Photon</topic><topic>Tomography, X-Ray Computed</topic><topic>Tumors of the nervous system. Phacomatoses</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rozovsky, Katia</creatorcontrib><creatorcontrib>Koplewitz, Benjamin Z</creatorcontrib><creatorcontrib>Krausz, Yodphat</creatorcontrib><creatorcontrib>Revel-Vilk, Shoshana</creatorcontrib><creatorcontrib>Weintraub, Michael</creatorcontrib><creatorcontrib>Chisin, Roland</creatorcontrib><creatorcontrib>Klein, Martine</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of roentgenology (1976)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rozovsky, Katia</au><au>Koplewitz, Benjamin Z</au><au>Krausz, Yodphat</au><au>Revel-Vilk, Shoshana</au><au>Weintraub, Michael</au><au>Chisin, Roland</au><au>Klein, Martine</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Added Value of SPECT/CT for Correlation of MIBG Scintigraphy and Diagnostic CT in Neuroblastoma and Pheochromocytoma</atitle><jtitle>American journal of roentgenology (1976)</jtitle><addtitle>AJR Am J Roentgenol</addtitle><date>2008-04-01</date><risdate>2008</risdate><volume>190</volume><issue>4</issue><spage>1085</spage><epage>1090</epage><pages>1085-1090</pages><issn>0361-803X</issn><eissn>1546-3141</eissn><coden>AAJRDX</coden><abstract>In pheochromocytoma and neuroblastoma, pathologic findings on metaiodobenzylguanidine (MIBG) scintigraphy (planar and SPECT) and on diagnostic CT are sometimes difficult to correlate. Furthermore, CT reading may be impaired by anatomic distortion after surgery or irradiation and if contrast agent is not injected. The present study evaluates the impact of SPECT/CT fusion images on correlation and image analysis of both techniques.
Eleven patients, three adults (age range, 27-64 years) with pheochromocytoma and eight children (age range, 16-72 months) with neuroblastoma, underwent 15 (123)I-MIBG scintigraphy (whole body and SPECT/CT) and diagnostic CT during follow-up after treatment, with a time interval of 2 to 30 days (mean, 12 days) between MIBG scintigraphy and diagnostic CT. The diagnostic CT scans were read twice: blindly and with knowledge of the SPECT/CT findings. The scintigraphic and anatomic data were subsequently compared and were verified by clinical outcome.
Of 15 imaging studies, there were nine cases of discordance between SPECT/CT and diagnostic CT, whereas concordant findings of planar MIBG and diagnostic CT were observed in six studies. Overall, SPECT/CT provided additional information in eight of the 15 cases (53%) and in eight of nine discordant studies (89%). In one case of pheochromocytoma in which anatomy was distorted by previous surgery and contrast agent was not injected, SPECT/CT findings guided the diagnostic CT that had initially misinterpreted the right adrenal gland as the inferior vena cava. In three of 11 studies performed for neuroblastoma, SPECT/CT facilitated the diagnostic CT reading: in one study, a small paravertebral thickening was overlooked at blind CT reading and in another case, SPECT/CT localized and characterized a soft-tissue mass medial to the iliac bone, which was missed on diagnostic CT in an area of difficult differential anatomy (bowel loops and eventual involved lymph nodes). In the third case, SPECT/CT directed the diagnostic CT to the MIBG abnormality after multiple surgical procedures. In these four cases, MIBG SPECT/CT allowed for localization of the pathologic site that was difficult to visualize on diagnostic CT. In four additional neuroblastoma studies in which a residual mass was present on diagnostic CT, planar MIBG scintigraphy was negative. SPECT/CT, focused on the area of the diagnostic CT abnormality, showed no focal MIBG uptake, thus increasing the diagnostic certainty of remission.
In cases of equivocal diagnostic CT, SPECT/CT bridges the gap between MIBG scintigraphy and diagnostic CT, with guidance of the diagnostic CT and characterization of its findings. In this small series, MIBG SPECT/CT increased the diagnostic certainty in 89% of discordant studies.</abstract><cop>Leesburg, VA</cop><pub>Am Roentgen Ray Soc</pub><pmid>18356459</pmid><doi>10.2214/AJR.07.2107</doi><tpages>6</tpages></addata></record> |
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| identifier | ISSN: 0361-803X |
| ispartof | American journal of roentgenology (1976), 2008-04, Vol.190 (4), p.1085-1090 |
| issn | 0361-803X 1546-3141 |
| language | eng |
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| source | American Roentgen Ray Society; MEDLINE; Alma/SFX Local Collection |
| subjects | 3-Iodobenzylguanidine Adrenal Gland Neoplasms - diagnostic imaging Adrenals. Adrenal axis. Renin-angiotensin system (diseases) Adult Biological and medical sciences Child Child, Preschool Endocrinopathies Female Humans Infant Investigative techniques, diagnostic techniques (general aspects) Male Medical sciences Middle Aged Neuroblastoma - diagnostic imaging Neurology Non tumoral diseases. Target tissue resistance. Benign neoplasms Pheochromocytoma - diagnostic imaging Radiopharmaceuticals Tomography, Emission-Computed, Single-Photon Tomography, X-Ray Computed Tumors of the nervous system. Phacomatoses |
| title | Added Value of SPECT/CT for Correlation of MIBG Scintigraphy and Diagnostic CT in Neuroblastoma and Pheochromocytoma |
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