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18 F‐ FDG PET / CT as a predictor of hereditary head and neck paragangliomas
Author(s) -
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
Publication year - 2014
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12239
Subject(s) - nuclear medicine , head and neck , medicine , univariate analysis , head and neck cancer , standardized uptake value , positron emission tomography , multivariate analysis , cancer , surgery
Background Hereditary head and neck paragangliomas ( HNPGL s) 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 18 F‐FDG PET/CT was not only able to detect and localize tumours, but also to characterize tumours ( 18 F‐FDG uptake being linked to SDH x mutations). However, the data concerning 18 F‐FDG uptake specifically in HNPGL s have not been addressed. The aim of this study was to evaluate the relationship between 18 F‐FDG uptake and the SDH x mutation status in HNPGL patients. Methods 18 F‐FDG PET/CT from sixty HNPGL patients were evaluated. For all lesions, we measured the maximum standardized uptake values ( SUV max), and the uptake ratio defined as HNPGL ‐ SUV max over pulmonary artery trunk SUV mean ( SUV ratio). Tumour sizes were assessed on radiological studies. Results Sixty patients (53·3% with SDH x mutations) were evaluated for a total of 106 HNPGL s. HNPGL s‐ SUV max and SUV ratio were highly dispersed (1·2–30·5 and 1·0–17·0, respectively). The HNPGL 18 F‐FDG uptake was significantly higher in SDH x versus sporadic tumours on both univariate and multivariate analysis ( P = 0·002). We developed two models for calculating the probability of a germline SDH x 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%. Conclusions 18 F‐FDG uptake in HNPGL is strongly dependent on patient genotype. Thus, the degree of 18 F‐FDG uptake in these tumours can be used clinically to help identify patients in whom SDH x mutations should be suspected.