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Background <p>Somatostatin-receptor (SSTR)—targeting PET/CT is widely used for diagnosis and disease monitoring of pheochromocytoma / paraganglioma (PPGL). The aim of this study was to assess the potential of the novel SSTR-targeting tracer [<sup>18</sup>F]SiTATE in diagnosing PPGL by comparing imaging parameters to tumor marker levels and secretory activity in a small cohort of patients diagnosed with this rare tumor type.</p> Methods <p>This retrospective study included 34 patients with histologically confirmed PPGL who underwent [<sup>18</sup>F]SiTATE-PET/CT at LMU University Hospital Munich between 10/2020 and 02/2024 as well as hormonal laboratory analysis within up to 100&#xa0;days. Imaging parameters&#xa0;—&#xa0;standardized uptake values (SUVmax, SUVmean), metabolic tumor volume (MTV), and total lesion uptake (TLU)&#xa0;—&#xa0;were analyzed. Uptake was normalized to liver background (SUVmaxr, SUVmeanr). Radioligand uptake of biochemical subtypes and genotypes was compared with Mann-Whitney-U test. Correlation was tested using Spearman´s rank correlation test.</p> Results <p>The patient-based detection rate of [<sup>18</sup>F]SiTATE-PET was 96.6%. A moderate correlation was found between MTV and TLU with chromogranin A (r = 0.570-0.608, p &lt; 0.005) and with biochemical secretion (r = 0.466-0.576, p &lt; 0.05). Hereditary PPGL with Cluster 1 genotype showed stronger [<sup>18</sup>F]SiTATE uptake compared to sporadic PPGL (SUVmeanr: p = 0.032; SUVmaxr: p = 0.051). A subgroup comparison with [⁶⁸Ga]Ga-DOTATOC-PET/CT revealed no significant difference in uptake metrics or tumor-to-background ratios.</p> Conclusion <p>This is the first clinical evaluation of [<sup>18</sup>F]SiTATE-PET/CT in patients with PPGL.&#xa0;MTV and TLU measured with [<sup>18</sup>F]SiTATE-PET/CT correlated well with the tumor marker chromogranin A in serum and with (nor)metanephrines in urine and plasma. Within the limits imposed by the small cohort, our results suggest that TLU and MTV in [<sup>18</sup>F]SiTATE-PET/CT could be used as SSTR imaging biomarker for monitoring of disease progression and secretory activity in patients with PPGL.</p>

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[18F]SiTATE-PET/CT for detection of pheochromocytomas and paragangliomas: comparison of biochemical secretion, genotype and imaging metrics

  • 期刊论文

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  • 发表日期：

    2025年5月30日

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  • Meike Onkes,
  • Paul Dahlmann,
  • Alena Gesenhues,
  • Sean Ira G. Gacula,
  • Nabeel Mansour,
  • Júnia R. O. L. Schweizer,
  • Isabel Stüfchen,
  • Christian Lottspeich,
  • Katharina Wang,
  • Matthias K. Auer,
  • Matthias Brendel,
  • Alessa Fischer,
  • Till Braunschweig,
  • Franz-Josef Gildehaus,
  • Simon Lindner,
  • Christine Schmid-Tannwald,
  • Thomas Pfluger,
  • Christoph J. Auernhammer,
  • Svenja Nölting,
  • Rudolf A. Werner,
  • Martin Reincke,
  • Martin Bidlingmaier,
  • Matthias Kroiss,
  • Friederike Völter

摘要

Background

Somatostatin-receptor (SSTR)—targeting PET/CT is widely used for diagnosis and disease monitoring of pheochromocytoma / paraganglioma (PPGL). The aim of this study was to assess the potential of the novel SSTR-targeting tracer [18F]SiTATE in diagnosing PPGL by comparing imaging parameters to tumor marker levels and secretory activity in a small cohort of patients diagnosed with this rare tumor type.

Methods

This retrospective study included 34 patients with histologically confirmed PPGL who underwent [18F]SiTATE-PET/CT at LMU University Hospital Munich between 10/2020 and 02/2024 as well as hormonal laboratory analysis within up to 100 days. Imaging parameters — standardized uptake values (SUVmax, SUVmean), metabolic tumor volume (MTV), and total lesion uptake (TLU) — were analyzed. Uptake was normalized to liver background (SUVmaxr, SUVmeanr). Radioligand uptake of biochemical subtypes and genotypes was compared with Mann-Whitney-U test. Correlation was tested using Spearman´s rank correlation test.

Results

The patient-based detection rate of [18F]SiTATE-PET was 96.6%. A moderate correlation was found between MTV and TLU with chromogranin A (r = 0.570-0.608, p < 0.005) and with biochemical secretion (r = 0.466-0.576, p < 0.05). Hereditary PPGL with Cluster 1 genotype showed stronger [18F]SiTATE uptake compared to sporadic PPGL (SUVmeanr: p = 0.032; SUVmaxr: p = 0.051). A subgroup comparison with [⁶⁸Ga]Ga-DOTATOC-PET/CT revealed no significant difference in uptake metrics or tumor-to-background ratios.

Conclusion

This is the first clinical evaluation of [18F]SiTATE-PET/CT in patients with PPGL. MTV and TLU measured with [18F]SiTATE-PET/CT correlated well with the tumor marker chromogranin A in serum and with (nor)metanephrines in urine and plasma. Within the limits imposed by the small cohort, our results suggest that TLU and MTV in [18F]SiTATE-PET/CT could be used as SSTR imaging biomarker for monitoring of disease progression and secretory activity in patients with PPGL.