18F-FDG PET/CT as a predictor of hereditary head and neck paragangliomas.
BACKGROUND
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 (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 SDHx mutations). However, the data concerning (18)F-FDG uptake specifically in HNPGLs have not been addressed. The aim of this study was to evaluate the relationship between (18)F-FDG uptake and the SDHx 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 (SUVmax), and the uptake ratio defined as HNPGL-SUVmax over pulmonary artery trunk SUVmean (SUVratio). Tumour sizes were assessed on radiological studies.


RESULTS
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 (18)F-FDG uptake was significantly higher in SDHx versus sporadic tumours on both univariate and multivariate analysis (P = 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%.


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 SDHx mutations should be suspected.
['Blanchet|Elise M|EM|', 'Gabriel|Sophie|S|', 'Martucci|Victoria|V|', 'Fakhry|Nicolas|N|', 'Chen|Clara C|CC|', 'Deveze|Arnaud|A|', 'Millo|Corina|C|', 'Barlier|Anne|A|', 'Pertuit|Morgane|M|', 'Loundou|Anderson|A|', 'Pacak|Karel|K|', 'Taïeb|David|D|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D051778:Basic Helix-Loop-Helix Leucine Zipper Transcription Factors D002648:Child D005260:Female D019788:Fluorodeoxyglucose F18 D020022:Genetic Predisposition to Disease D005838:Genotype D006258:Head and Neck Neoplasms D006801:Humans D008297:Male D008565:Membrane Proteins D008875:Middle Aged D024101:Mitochondrial Proteins D064847:Multimodal Imaging D015999:Multivariate Analysis D009386:Neoplastic Syndromes, Hereditary D010236:Paraganglioma, Extra-Adrenal D049268:Positron-Emission Tomography D019275:Radiopharmaceuticals D013385:Succinate Dehydrogenase D014057:Tomography, X-Ray Computed D051794:Von Hippel-Lindau Tumor Suppressor Protein D055815:Young Adult
head and neck paraganglioma Fluorodeoxyglucose PET-CT genetics hereditary cancer radiopharmaceuticals