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Influence of SPECT on interpretation of 123I-mIBG scintigraphy in patients with known or suspected pheochromocytoma and neuroblastoma

¹ Medical Diagnostics, GE Healthcare, Princeton, New Jersey; ² Nuc Med, Mt Sinai Hosp, New York, New York; ³ Nuc Med, U Miami Hosp, Miami, Florida; ⁴ Radiology, Piedmont Hosp, Atlanta, Georgia

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Objectives: This study assessed the impact of SPECT on the interpretation of 123I-mIBG studies for the evaluation of patients (pts) with known or suspected pheochromocytoma and neuroblastoma.

Methods: In a prospective multicenter trial, 149 pts with known or suspected pheochromocytoma and 51 with known or suspected neuroblastoma underwent whole-body planar and chest/abdomen SPECT imaging 24 (± 6) hours following administration of 123I-mIBG, 10 mCi (370 MBq) for adults and 1-10 mCi (37-370 MBq) for children. 3 blinded readers examined planar images alone first, then perfomed a combined interpretation with planar plus SPECT. Consensus required at least 2 readers in agreement. Confirmation of disease was based upon histopathology, other imaging, catecholamine measurements, and clinical follow-up.

Results: 122 pts had active disease, 57 were judged without disease, and 21 were considered indeterminate based upon inadequate follow-up data. 123I-mIBG planar scintigraphy had a sensitivity (Se) of 81% (99/122) and specificity (Sp) of 79% (45/57). With SPECT, there was a modest increase in Se (86%; 105/122) with minimal change in Sp (77%; 44/57). SPECT changed the interpretations of 17 studies: negative to positive -12 (9 true-positive); positive to negative – 5 (2 true-negative). SPECT clarified findings on planar imaging in 38-46% and provided additional diagnostic value in 32-41% of pts.

Conclusions: While providing a small improvement in quantitative performance, 123I-mIBG SPECT assisted the readers’ interpretation in almost half the pts. The greatest impact of SPECT was to increase the number of positive studies, both true- and false-positive.

Research Support: GE Healthcare

This Article Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Serafini, A. Articles by Jacobson, A. PubMed Articles by Serafini, A. Articles by Jacobson, A.