{"doi":"10.1007/s00330-024-10652-4","title":"Diagnostic performance of [68Ga]DOTATATE PET/CT, [18F]FDG PET/CT, MRI of the spine, and whole-body diagnostic CT and MRI in the detection of spinal bone metastases associated with pheochromocytoma and paraganglioma","abstract":"Abstract Objective To compare the diagnostic performance of [ 68 Ga]DOTATATE PET/CT, [ 18 F]FDG PET/CT, MRI of the spine, and whole-body CT and MRI for the detection of pheochromocytoma/paraganglioma (PPGL)–related spinal bone metastases. Materials and methods Between 2014 and 2020, PPGL participants with spinal bone metastases prospectively underwent [ 68 Ga]DOTATATE PET/CT, [ 18 F]FDG PET/CT, MRI of the cervical-thoracolumbar spine (MRI spine ), contrast-enhanced MRI of the neck and thoraco-abdominopelvic regions (MRI WB ), and contrast-enhanced CT of the neck and thoraco-abdominopelvic regions (CT WB ). Per-patient and per-lesion detection rates were calculated. Counting of spinal bone metastases was limited to a maximum of one lesion per vertebrae. A composite of all functional and anatomic imaging served as an imaging comparator. The McNemar test compared detection rates between the scans. Two-sided p values were reported. Results Forty-three consecutive participants (mean age, 41.7 ± 15.7 years; females, 22) with MRI spine were included who also underwent [ 68 Ga]DOTATATE PET/CT ( n = 43), [ 18 F]FDG PET/CT ( n = 43), MRI WB ( n = 24), and CT WB ( n = 33). Forty-one of 43 participants were positive for spinal bone metastases, with 382 lesions on the imaging comparator. [ 68 Ga]DOTATATE PET/CT demonstrated a per-lesion detection rate of 377/382 (98.7%) which was superior compared to [ 18 F]FDG (72.0%, 275/382, p < 0.001), MRI spine (80.6%, 308/382, p < 0.001), MRI WB (55.3%, 136/246, p < 0.001), and CT WB (44.8%, 132/295, p < 0.001). The per-patient detection rate of [ 68 Ga]DOTATATE PET/CT was 41/41 (100%) which was higher compared to [ 18 F]FDG PET/CT (90.2%, 37/41, p = 0.13), MRI spine (97.6%, 40/41, p = 1.00), MRI WB (95.7%, 22/23, p = 1.00), and CT WB (81.8%, 27/33, p = 0.03). Conclusions [ 68 Ga]DOTATATE PET/CT should be the modality of choice in PPGL-related spinal bone metastases due to its superior detection rate. Clinical relevance statement In a prospective study of 43 pheochromocytoma/paraganglioma participants with spinal bone metastases, [ 68 Ga]DOTATATE PET/CT had a superior per-lesion detection rate of 98.7% (377/382), compared to [ 18 F]FDG PET/CT ( p < 0.001), MRI of the spine ( p < 0.001), whole-body CT ( p < 0.001), and whole-body MRI ( p < 0.001). Graphical abstract Key Points • Data regarding head-to-head comparison between functional and anatomic imaging modalities to detect spinal bone metastases in pheochromocytoma/paraganglioma are limited. • [ 68 Ga ] DOTATATE PET/CT had a superior per-lesion detection rate of 98.7% in the detection of spinal bone metastases associated with pheochromocytoma/paraganglioma compared to other imaging modalities: [ 18 ]F-FDG PET/CT, MRI of the spine, whole-body CT, and whole-body MRI. • [ 68 Ga ] DOTATATE PET/CT should be the modality of choice in the evaluation of spinal bone metastases associated with pheochromocytoma/paraganglioma.","journal":"European Radiology","year":2024,"id":425463,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":19,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.866,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":484972,"name":"Mayank Patel","orcid":"0000-0002-6609-5394","position":1,"is_corresponding":false},{"id":299294,"name":"Alexander Ling","orcid":"0000-0001-6194-9875","position":2,"is_corresponding":false},{"id":685818,"name":"Ritu Shah","orcid":null,"position":3,"is_corresponding":false},{"id":632332,"name":"Clara C. 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