Bo Li, Xintao Ding, Jie Zhang, Minmin Tang, Huimin Liu, Xinyu Wu, Yongju Gao
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Additionally, visual and semiquantitative evaluations were performed using Krenning score (KS) and tumor-to-background ratio (TBR), and their diagnostic performances were analyzed. Of the 75 patients, 54 had PPGLs (40 pheochromocytomas, 7 paragangliomas, and 7 metastatic PPGLs), and 21 had non-PPGL tumors. [<sup>99m</sup>Tc]Tc-HYNIC-TOC SPECT/CT showed positive imaging in 63 patients, of whom 51 were confirmed as PPGLs and 12 as non-PPGLs. The sensitivity, specificity, PPV, NPV, and overall accuracy were 94.4% (51/54), 42.9% (9/21), 80.9% (51/63), 75.0% (9/12), and 80.0% (60/75), respectively. Visual and semiquantitative evaluations indicated higher KS and TBR values in PPGLs compared to non-PPGLs (median KS: 3.0 vs. 1.0, P < 0.001; median TBR: 2.10 vs. 0.92, P < 0.001). The Receiver operating characteristic (ROC) analysis revealed AUCs of 0.803 for KS and 0.791 for TBR, with no significant difference in their diagnostic performance (P = 0.710). Metastatic PPGLs were detected in 7 cases, with metastases observed in multiple organs. [<sup>99m</sup>Tc]Tc-HYNIC-TOC SPECT/CT effectively diagnoses PPGL and identifies metastatic disease. Despite lacking comparative evaluation with established tracers, it represents a cost-effective alternative for PPGL evaluation, particularly in resource-limited settings where PET/CT access is restricted, bridging diagnostic gaps while maintaining acceptable accuracy.</p>","PeriodicalId":21811,"journal":{"name":"Scientific Reports","volume":"15 1","pages":"27493"},"PeriodicalIF":3.9000,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12304395/pdf/","citationCount":"0","resultStr":"{\"title\":\"Evaluating the diagnostic accuracy of <sup>99m</sup>Tc-labeled somatostatin receptor imaging for suspected pheochromocytomas and paragangliomas.\",\"authors\":\"Bo Li, Xintao Ding, Jie Zhang, Minmin Tang, Huimin Liu, Xinyu Wu, Yongju Gao\",\"doi\":\"10.1038/s41598-025-12794-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Pheochromocytomas and paragangliomas (PPGLs) present diagnostic challenges due to their diverse clinical manifestations. This study aims to evaluate the diagnostic accuracy of [<sup>99m</sup>Tc]Tc-HYNIC-TOC SPECT/CT in patients with clinically suspected PPGLs. A retrospective analysis was conducted on 75 patients (36 males, 39 females, mean age 47.7 ± 14.9 years) with suspected PPGLs. All patients underwent [<sup>99m</sup>Tc]Tc-HYNIC-TOC SPECT/CT imaging, and the results were compared with histopathological findings. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy of the imaging modality were calculated. Additionally, visual and semiquantitative evaluations were performed using Krenning score (KS) and tumor-to-background ratio (TBR), and their diagnostic performances were analyzed. Of the 75 patients, 54 had PPGLs (40 pheochromocytomas, 7 paragangliomas, and 7 metastatic PPGLs), and 21 had non-PPGL tumors. [<sup>99m</sup>Tc]Tc-HYNIC-TOC SPECT/CT showed positive imaging in 63 patients, of whom 51 were confirmed as PPGLs and 12 as non-PPGLs. The sensitivity, specificity, PPV, NPV, and overall accuracy were 94.4% (51/54), 42.9% (9/21), 80.9% (51/63), 75.0% (9/12), and 80.0% (60/75), respectively. Visual and semiquantitative evaluations indicated higher KS and TBR values in PPGLs compared to non-PPGLs (median KS: 3.0 vs. 1.0, P < 0.001; median TBR: 2.10 vs. 0.92, P < 0.001). The Receiver operating characteristic (ROC) analysis revealed AUCs of 0.803 for KS and 0.791 for TBR, with no significant difference in their diagnostic performance (P = 0.710). Metastatic PPGLs were detected in 7 cases, with metastases observed in multiple organs. [<sup>99m</sup>Tc]Tc-HYNIC-TOC SPECT/CT effectively diagnoses PPGL and identifies metastatic disease. 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引用次数: 0
摘要
嗜铬细胞瘤和副神经节瘤（PPGLs）由于其不同的临床表现，目前的诊断挑战。本研究旨在评价[99mTc]Tc-HYNIC-TOC SPECT/CT对临床疑似ppgl患者的诊断准确性。对75例疑似ppgl患者（男36例，女39例，平均年龄47.7±14.9岁）进行回顾性分析。所有患者均行[99mTc]Tc-HYNIC-TOC SPECT/CT成像，并与组织病理学结果进行比较。计算成像方式的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和总体准确性。此外，采用Krenning评分（KS）和肿瘤与背景比（TBR）进行视觉和半定量评价，并分析其诊断性能。75例患者中，54例为ppgl（嗜铬细胞瘤40例，副神经节瘤7例，转移性ppgl 7例），21例为非ppgl肿瘤。[99mTc]Tc-HYNIC-TOC SPECT/CT显示阳性63例，其中51例确诊为PPGLs， 12例为非PPGLs。灵敏度为94.4%(51/54)，特异度为42.9% (9/21)，PPV为80.9% (51/63)，NPV为75.0%(9/12)，总准确率为80.0%（60/75）。视觉和半定量评估显示，PPGL患者的KS和TBR值高于非PPGL患者（中位KS: 3.0 vs. 1.0, P = 99mTc）， tc - hyic - toc SPECT/CT有效诊断PPGL并识别转移性疾病。尽管缺乏与现有示踪剂的比较评估，但它代表了一种具有成本效益的PPGL评估替代方案，特别是在资源有限的环境中，PET/CT访问受限，在保持可接受的准确性的同时弥合诊断差距。
Evaluating the diagnostic accuracy of 99mTc-labeled somatostatin receptor imaging for suspected pheochromocytomas and paragangliomas.
Pheochromocytomas and paragangliomas (PPGLs) present diagnostic challenges due to their diverse clinical manifestations. This study aims to evaluate the diagnostic accuracy of [99mTc]Tc-HYNIC-TOC SPECT/CT in patients with clinically suspected PPGLs. A retrospective analysis was conducted on 75 patients (36 males, 39 females, mean age 47.7 ± 14.9 years) with suspected PPGLs. All patients underwent [99mTc]Tc-HYNIC-TOC SPECT/CT imaging, and the results were compared with histopathological findings. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy of the imaging modality were calculated. Additionally, visual and semiquantitative evaluations were performed using Krenning score (KS) and tumor-to-background ratio (TBR), and their diagnostic performances were analyzed. Of the 75 patients, 54 had PPGLs (40 pheochromocytomas, 7 paragangliomas, and 7 metastatic PPGLs), and 21 had non-PPGL tumors. [99mTc]Tc-HYNIC-TOC SPECT/CT showed positive imaging in 63 patients, of whom 51 were confirmed as PPGLs and 12 as non-PPGLs. The sensitivity, specificity, PPV, NPV, and overall accuracy were 94.4% (51/54), 42.9% (9/21), 80.9% (51/63), 75.0% (9/12), and 80.0% (60/75), respectively. Visual and semiquantitative evaluations indicated higher KS and TBR values in PPGLs compared to non-PPGLs (median KS: 3.0 vs. 1.0, P < 0.001; median TBR: 2.10 vs. 0.92, P < 0.001). The Receiver operating characteristic (ROC) analysis revealed AUCs of 0.803 for KS and 0.791 for TBR, with no significant difference in their diagnostic performance (P = 0.710). Metastatic PPGLs were detected in 7 cases, with metastases observed in multiple organs. [99mTc]Tc-HYNIC-TOC SPECT/CT effectively diagnoses PPGL and identifies metastatic disease. Despite lacking comparative evaluation with established tracers, it represents a cost-effective alternative for PPGL evaluation, particularly in resource-limited settings where PET/CT access is restricted, bridging diagnostic gaps while maintaining acceptable accuracy.
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