目的:多种放射性核素成像技术可用于诊断,分期,嗜铬细胞瘤和副神经节瘤(PPGL)的随访。除了他们检测和定位疾病的能力之外,这些成像方法在细胞和分子水平上可变地表征了这些肿瘤,并可以指导治疗。在这里,我们提出了由EANM和SNMMI联合批准的最新指南,以帮助核医学从业人员不仅选择和执行当前可用的单光子发射计算机断层扫描和正电子发射断层扫描程序,还有结果的解释和报告。
方法:相关领域的指南和相关文献已与参与PPGL管理的领先专家协商考虑。应根据当地法律法规以及各种放射性药物的可用性应用所提供的信息。
结论:自欧洲核医学协会2012年指南以来,近年来使用镓-68(68Ga)标记的生长抑素类似物(SSAs)获得的优异结果简化了PPGL患者的成像方法,该方法也可用于选择接受肽受体放射性核素治疗的患者,作为传统的碘123(123I)/碘131(131I)标记的间碘联苯胺治疗方法的潜在替代或补充.具有不同病变发展和随后转移扩散风险的亚组的基因组表征正在完善分子成像在遗传性PPGL患者的个性化检测方法中的应用。分期,和后续监控。
OBJECTIVE: Diverse radionuclide imaging techniques are available for the diagnosis, staging, and follow-up of phaeochromocytoma and paraganglioma (PPGL). Beyond their ability to detect and localise the disease, these imaging approaches variably characterise these tumours at the cellular and molecular levels and can guide therapy. Here we present updated
guidelines jointly approved by the EANM and SNMMI for assisting nuclear medicine practitioners in not only the selection and performance of currently available single-photon emission computed tomography and positron emission tomography procedures, but also the interpretation and reporting of the results.
METHODS: Guidelines from related fields and relevant literature have been considered in consultation with leading experts involved in the management of PPGL. The provided information should be applied according to local laws and regulations as well as the availability of various radiopharmaceuticals.
CONCLUSIONS: Since the European Association of Nuclear Medicine 2012
guidelines, the excellent results obtained with gallium-68 (68Ga)-labelled somatostatin analogues (SSAs) in recent years have simplified the imaging approach for PPGL patients that can also be used for selecting patients for peptide receptor radionuclide therapy as a potential alternative or complement to the traditional theranostic approach with iodine-123 (123I)/iodine-131 (131I)-labelled meta-iodobenzylguanidine. Genomic characterisation of subgroups with differing risk of lesion development and subsequent metastatic spread is refining the use of molecular imaging in the personalised approach to hereditary PPGL patients for detection, staging, and follow-up surveillance.