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68Ga-DOTATATE PET in Pediatric Paraganglioma / Pheochromocytoma: A Case-series Highlighting the Role of Functional Imaging
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  • Aleksandra Augustynowicz,
  • Neha Kwatra,
  • Laura Drubach,
  • Christopher Weldon,
  • Katherine Janeway,
  • Steven DuBois,
  • Junne Kamihara,
  • Stephan Voss
Aleksandra Augustynowicz
Mt Auburn Hospital
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Neha Kwatra
Harvard Medical School
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Laura Drubach
Harvard Medical School
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Christopher Weldon
Boston Children’s Hospital and Harvard Medical School
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Katherine Janeway
Dana-Farber / Boston Children's Cancer and Blood Disorders Center
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Steven DuBois
Dana-Farber Cancer Institute
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Junne Kamihara
Dana-Farber Cancer Institute
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Stephan Voss
Harvard Medical School
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Abstract

Pheochromocytoma and paraganglioma (PPGL) are rare neuroendocrine tumors in childhood. Cancer predisposition syndromes (CPS) are increasingly recognized as the underlying cause for a number of pediatric malignancies and up to 40% of PPGL are currently thought to be associated with a hereditary predisposition1,2. With the increasingly widespread availability of functional molecular imaging techniques, nuclear medicine imaging modalities such as 18F-FDG-PET/CT, 123I-MIBG SPECT/CT, and 68Ga-DOTATATE PET/CT now play an essential role in the staging, response assessment and determination of suitability for targeted radiotherapy in patients with PPGL. Each of these imaging modalities targets a different cellular characteristic, such as glucose metabolism (FDG), norepinephrine transporter expression (MIBG), or somatostatin receptor expression (DOTATATE), and therefore can be complementary to anatomic imaging and to each other. Given the recent FDA approval3 and increasing use of 68Ga-DOTATATE for imaging in children4, the purpose of this article is to use a case-based approach to highlight both the advantages and limitations of DOTATATE imaging as it compares to current radiologic imaging techniques in the staging and response assessment of pediatric PPGL, and to offer a decision algorithm for the use of functional imaging that can be applied to PPGL, as well as other neuroendocrine malignancies.
06 Dec 2021Submission Checks Completed
06 Dec 2021Assigned to Editor
06 Dec 2021Submitted to Pediatric Blood & Cancer
08 Dec 2021Reviewer(s) Assigned
22 Dec 2021Review(s) Completed, Editorial Evaluation Pending
28 Dec 2021Editorial Decision: Revise Major
01 Mar 2022Submission Checks Completed
01 Mar 2022Assigned to Editor
01 Mar 20221st Revision Received
01 Mar 2022Reviewer(s) Assigned
11 Mar 2022Review(s) Completed, Editorial Evaluation Pending
29 Mar 2022Editorial Decision: Accept