Article Text

Download PDFPDF
Combined positron emission tomography/computed tomography (PET/CT) for imaging of orbital tumours and tumours extending into the orbit
  1. Annemarie Klingenstein1,
  2. Gerd-Ullrich Mueller-Lisse2,
  3. Alexander R Haug3,4,
  4. Aylin Garip-Kuebler1,
  5. Christina V Miller1,
  6. Christoph R Hintschich1
  1. 1Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
  2. 2Department of Radiology, Ludwig-Maximilians-University, Munich, Germany
  3. 3Department of Nuclear Medicine, Ludwig-Maximilians-University, Munich, Germany
  4. 4Division of Nuclear Medicine, Medical University Vienna, Vienna, Austria
  1. Correspondence to Dr Annemarie Klingenstein, Ludwig-Maximilians-University, Department of Ophthalmology, Klinikum der Universität München, Campus Innenstadt, Mathildenstraße 8, Munich D-80336, Germany; Annemarie.Klingenstein{at}


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.

  • Imaging
  • Neoplasia
  • Orbit

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • At a glance
    Keith Barton James Chodosh Jost Jonas