In a patient with suspected phaeochromocytoma/paraganglioma syndrome with biochemical confirmation, which PET tracer has the highest sensitivity for localisation compared to MIBG scintigraphy?
- A FDG (fluorodeoxyglucose)
- B Fluorocholine
- C DOTA-TATE (gallium-68 somatostatin analogue) ✓
- D PSMA (prostate-specific membrane antigen) PET
Correct answer: C. DOTA-TATE (gallium-68 somatostatin analogue)
Explanation
Gallium-68 DOTA-TATE PET/CT has superior sensitivity (>90%) for phaeochromocytoma and paraganglioma compared to MIBG scintigraphy (~70–80%), particularly for metastatic, extra-adrenal, and SDHB-mutation related tumours which overexpress somatostatin receptors. DOTA-TATE also offers superior spatial resolution vs. MIBG. FDG-PET is particularly useful in SDHB-associated tumours (which are FDG-avid) but DOTA-TATE is preferred overall. Fluorocholine targets choline metabolism and is used in prostate cancer. PSMA PET is prostate-cancer specific.
Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.