Klingenstein A, Mueller-Lisse GU, Haug AR, Garip-Kuebler A, Miller CV, Hintschich CR. Combined positron emission tomography/computed tomography (PET/CT) for imaging of orbital tumours and tumours extending into the orbit.
Br J Ophthalmol 2016;
100:1403-8. [PMID:
26769673 DOI:
10.1136/bjophthalmol-2015-307988]
[Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 12/13/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVE
To assess clinical and radiological performance of combined positron emission tomography/computed tomography (PET/CT) in patients with secondary and primary intraorbital tumours.
METHODS
14 adults with secondary and 1 child with primary orbital masses underwent combined whole-body PET/CT. Radiopharmaceutical tracers applied were (18F)-fluorodeoxyglucose, (18F)-fluoroethylcholine (FEC) and (68Ga)-DOTATATE. Histopathology and/or all conventional radiographic work-up and clinical course served as standard of reference. Descriptive statistics and Fisher's exact test were used for analysis.
RESULTS
PET/CT detected all orbital masses. All 15 patients had malignant disease. Local osseous infiltration was correctly identified in 11 patients. Lymph node metastases were present in two of eight patients (25%) with haematogenous orbital metastases and in five of six patients (83%) with infiltrative carcinoma (p=0.05). Further distant metastases were present in all eight patients suffering from orbital metastases, but only one patient with infiltrative carcinoma (17%) presented with disseminated disease (p=0.003). In one metastasis, PET/CT excluded vital orbital tumour tissue after radiation therapy. Local recurrence was detected in another patient suffering from prostate cancer.
CONCLUSION
PET/CT is a sensitive tool for the detection and localisation of orbital masses, enabling assessment of both morphology and cell metabolism. Detailed imaging of the head and neck region with a small field-of-view should be performed when suspecting lymphatic metastases. As metastatic disease to the orbit is associated with advanced disease, focus should be laid on whole-body imaging for staging of these patients. Different radiopharmaceutical tracers can be applied to distinguish the origin of orbital metastases.
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