Abstract：
BACKGROUND: The purpose of the study was to determine the usefulness of Ga-68 DOTATATE PET/MR in the identification of tumours in individuals with multiple endocrine neoplasia type 1 (MEN1).
METHODS: In this retrospective investigation, five individuals who had tested positive for a hereditary MEN1 variant underwent Ga-68 DOTATATE PET/MR between May 2020 and January 2023. Several types of tumours associated with MEN1 were studied. MEN1-related tumours included pituitary, parathyroid, gastroenteropancreatic, and adrenal. The rates of lesion identification between MRI, Ga-68 DOTATATE PET, and Ga-68 DOTATATE PET/MRI were examined. The maximum and mean standard uptake values (SUVmax and SUVmean) were evaluated in carefully delineated volumes of interest (VOI) for the relevant tumours.
RESULTS: Of the 24 primary lesions, 14 were identified by Ga-68 DOTATATE PET, 18 by MRI, and 20 by Ga-68 DOTATATE PET/MRI. Two pituitary tumours were detected by all three techniques. All parathyroid tumours that were not detected by Ga-68 DOTATATE PET and MRI were found by Tc-99m MIBI SPECT/CT or/and EUS. Ga-68 DOTATATE PET/MR detected more gastroenteropancreatic lesions. All adrenal tumours not identified by Ga-68 DOTATATE PET were found by MRI or CT. The median SUVmax for lesions identified on Ga-68 DOTATATE PET/MRI was 18.4 (range, 3.8-85.2), and the median SUVmean was 12.0 (range, 2.3-49.8).
CONCLUSIONS: The combination of Ga-68 DOTATATE PET and MRI demonstrated a higher detection rate and may be more useful in the work-up of MEN1 providing a panoramic view of MEN1-related lesions. To increase the identification of MEN1-associated neuroendocrine lesions in the parathyroid gland, approaches other than Ga-68 DOTATATE PET/MRI should be used.
METHODS: In this retrospective investigation, five individuals who had tested positive for a hereditary MEN1 variant underwent Ga-68 DOTATATE PET/MR between May 2020 and January 2023. Several types of tumours associated with MEN1 were studied. MEN1-related tumours included pituitary, parathyroid, gastroenteropancreatic, and adrenal. The rates of lesion identification between MRI, Ga-68 DOTATATE PET, and Ga-68 DOTATATE PET/MRI were examined. The maximum and mean standard uptake values (SUVmax and SUVmean) were evaluated in carefully delineated volumes of interest (VOI) for the relevant tumours.
RESULTS: Of the 24 primary lesions, 14 were identified by Ga-68 DOTATATE PET, 18 by MRI, and 20 by Ga-68 DOTATATE PET/MRI. Two pituitary tumours were detected by all three techniques. All parathyroid tumours that were not detected by Ga-68 DOTATATE PET and MRI were found by Tc-99m MIBI SPECT/CT or/and EUS. Ga-68 DOTATATE PET/MR detected more gastroenteropancreatic lesions. All adrenal tumours not identified by Ga-68 DOTATATE PET were found by MRI or CT. The median SUVmax for lesions identified on Ga-68 DOTATATE PET/MRI was 18.4 (range, 3.8-85.2), and the median SUVmean was 12.0 (range, 2.3-49.8).
CONCLUSIONS: The combination of Ga-68 DOTATATE PET and MRI demonstrated a higher detection rate and may be more useful in the work-up of MEN1 providing a panoramic view of MEN1-related lesions. To increase the identification of MEN1-associated neuroendocrine lesions in the parathyroid gland, approaches other than Ga-68 DOTATATE PET/MRI should be used.
摘要：
背景：该研究的目的是确定Ga-68DOTATATEPET/MR在识别患有1型多发性内分泌肿瘤（MEN1）的个体中的肿瘤中的有用性。
方法：在这项回顾性调查中，在2020年5月至2023年1月期间,5例遗传性MEN1变异体检测呈阳性的患者接受了Ga-68DOTATATEPET/MR检查.研究了与MEN1相关的几种类型的肿瘤。MEN1相关肿瘤包括垂体，甲状旁腺,胃肠胰,和肾上腺。MRI之间的病变识别率，Ga-68DOTATATEPET,和Ga-68DOTATATEPET/MRI检查。在仔细描绘相关肿瘤的感兴趣体积(VOI)中评估最大和平均标准摄取值(SUVmax和SUVmean)。
结果：在24个原发灶中，14个由Ga-68DOTATATEPET鉴定，18MRI，和20通过Ga-68DOTATATEPET/MRI。通过所有三种技术检测到两个垂体肿瘤。通过Tc-99mMIBISPECT/CT或/和EUS发现了所有未通过Ga-68DOTATATEPET和MRI检测到的甲状旁腺肿瘤。Ga-68DOTATATEPET/MR检测到更多的胃肠胰腺病变。所有未通过Ga-68DOTATATEPET鉴定的肾上腺肿瘤均通过MRI或CT发现。在Ga-68DOTATATEPET/MRI上确定的病变的中位SUVmax为18.4（范围，3.8-85.2),SUVmean中位数为12.0(范围，2.3-49.8)。
结论：Ga-68DOTATATEPET和MRI的组合显示出更高的检出率，并且可能在MEN1的后处理中更有用，从而提供MEN1相关病变的全景视图。为了增加对甲状旁腺中MEN1相关神经内分泌病变的识别，应使用Ga-68DOTATATEPET/MRI以外的方法。
方法：在这项回顾性调查中，在2020年5月至2023年1月期间,5例遗传性MEN1变异体检测呈阳性的患者接受了Ga-68DOTATATEPET/MR检查.研究了与MEN1相关的几种类型的肿瘤。MEN1相关肿瘤包括垂体，甲状旁腺,胃肠胰,和肾上腺。MRI之间的病变识别率，Ga-68DOTATATEPET,和Ga-68DOTATATEPET/MRI检查。在仔细描绘相关肿瘤的感兴趣体积(VOI)中评估最大和平均标准摄取值(SUVmax和SUVmean)。
结果：在24个原发灶中，14个由Ga-68DOTATATEPET鉴定，18MRI，和20通过Ga-68DOTATATEPET/MRI。通过所有三种技术检测到两个垂体肿瘤。通过Tc-99mMIBISPECT/CT或/和EUS发现了所有未通过Ga-68DOTATATEPET和MRI检测到的甲状旁腺肿瘤。Ga-68DOTATATEPET/MR检测到更多的胃肠胰腺病变。所有未通过Ga-68DOTATATEPET鉴定的肾上腺肿瘤均通过MRI或CT发现。在Ga-68DOTATATEPET/MRI上确定的病变的中位SUVmax为18.4（范围，3.8-85.2),SUVmean中位数为12.0(范围，2.3-49.8)。
结论：Ga-68DOTATATEPET和MRI的组合显示出更高的检出率，并且可能在MEN1的后处理中更有用，从而提供MEN1相关病变的全景视图。为了增加对甲状旁腺中MEN1相关神经内分泌病变的识别，应使用Ga-68DOTATATEPET/MRI以外的方法。
