18F‐FDG PET/CT as a predictor of hereditary head and neck paragangliomas. (March 2014)

• Record Type: Journal Article
• Authors: Blanchet, Elise M.; Gabriel, Sophie; Martucci, Victoria; Fakhry, Nicolas; Chen, Clara C.; Deveze, Arnaud; Millo, Corina; Barlier, Anne; Pertuit, Morgane; Loundou, Anderson; Pacak, Karel; Taïeb, David
• Is Part Of: European journal of clinical investigation. Volume 44:Number 3(2014:Mar.)
• Page Start: 325
• Page End: 332
• Publication Date: 2014-03
• Subjects: Pathology -- Periodicals; Medical research -- Periodicals; 616.075
• DOI: 10.1111/eci.12239
• Languages: English
• ISSNs: 0014-2972

Abstract

<abstract abstract-type="main" id="eci12239-abs-0001"> <title>Abstract</title> <sec id="eci12239-sec-0001" sec-type="section"> <title>Background</title> <p>Hereditary head and neck paragangliomas (HNPGLs) account for at least 35% of all HNPGLs, most commonly due to germline mutations in SDHx susceptibility genes. Several studies about sympathetic paragangliomas have shown that <sup>18</sup>F‐FDG PET/CT was not only able to detect and localize tumours, but also to characterize tumours (<sup>18</sup>F‐FDG uptake being linked to SDHx mutations). However, the data concerning <sup>18</sup>F‐FDG uptake specifically in HNPGLs have not been addressed. The aim of this study was to evaluate the relationship between <sup>18</sup>F‐FDG uptake and the SDHx mutation status in HNPGL patients.</p> </sec> <sec id="eci12239-sec-0002" sec-type="section"> <title>Methods</title> <p> <sup>18</sup>F‐FDG PET/CT from sixty HNPGL patients were evaluated. For all lesions, we measured the maximum standardized uptake values (SUVmax), and the uptake ratio defined as HNPGL‐SUVmax over pulmonary artery trunk SUVmean (SUVratio). Tumour sizes were assessed on radiological studies.</p> </sec> <sec id="eci12239-sec-0003" sec-type="section"> <title>Results</title> <p>Sixty patients (53·3% with SDHx mutations) were evaluated for a total of 106 HNPGLs. HNPGLs‐SUVmax and SUVratio were highly dispersed (1·2–30·5 and 1·0–17·0, respectively). The HNPGL <sup>18</sup>F‐FDG uptake was significantly higher in SDHx versus sporadic tumours on both univariate and multivariate analysis (<italic>P</italic> = 0·002). We developed two models for calculating the probability of a germline SDHx mutation. The first one, based on a per‐lesion analysis, had an accuracy of 75·5%. The second model, based on a per‐patient analysis, had an accuracy of 80·0%.</p> </sec> <sec id="eci12239-sec-0004" sec-type="section"> <title>Conclusions</title> <p> <sup>18</sup>F‐FDG uptake in HNPGL is strongly dependent on patient genotype. Thus, the degree of <sup>18</sup>F‐FDG uptake in these tumours can be used clinically to help identify patients in whom SDHx mutations should be suspected.</p> </sec> </abstract>