Morphological and functional imaging of neck paragangliomas - 01/08/17

Doi : 10.1016/j.anorl.2016.10.003

J.-P. Guichard ^a, N. Fakhry ^b,^⁎ , J. Franc ^a, P. Herman ^c, C.-A. Righini ^d,^e, D. Taieb ^f
^a Department of Neurovascular Imaging, H"pital LariboisiSre, AP-HP, Universit, Paris 7 Denis Diderot, 75010 Paris, France
^b Service d’ORL et chirurgie cervicofaciale, Aix-Marseille université, CHU La Conception, 147, boulevard Baille, 13005 Marseille, France
^c Department of Head and Neck surgery, LariboisiSre Hospital, AP-HP, University Paris-Diderot Paris 7, 75010 Paris, France
^d Pôle médecine, Université des Alpes, CHU des Alpes, Clinique Universitaire d’ORL, Pôle PALCROS, 38043 Grenoble, France
^e UFR médecine, université Joseph-Fourier, domaine de la Merci, 38700 La Tronche, France
^f Service central de biophysique et de médecine nucléaire, Aix-Marseille université, CHU La Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France

^⁎Corresponding author.

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Abstract

Objective

To review the optimal techniques for localization and characterization of neck paragangliomas (PGL).

Material and methods

Systematic review of the literature from the PubMed/Medline database.

Results

Neck PGL are hypervascular tumours essentially arising from paraganglionic tissue situated at the carotid bifurcation (carotid body) and along the vagus nerve. Morphological and functional imaging are indicated to confirm the diagnosis, identify multifocal disease and for local and regional staging. MR angiography is the noninvasive technique of choice. CT scan and especially CT angiography are excellent alternatives for diagnosis and staging. Conventional arteriography remains useful preoperatively for embolization and occlusion tests. Functional imaging allows localization and characterization of PGLs. Somatostatin receptor scintigraphy (SRS) was the reference imaging technique for staging of sporadic PGLs. The indications for PET imaging have been extended over recent years in parallel with the development of new tracers such as [¹⁸F]-FDOPA PET or ⁶⁸Gallium-labelled DOTA peptides. ⁶⁸Gallium-labelled DOTA peptides has become the first-line imaging modality in the evaluation of cervical PGLs, regardless of the genetic background.