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Use of 6‐[ 18 F]‐fluorodopamine positron emission tomography (PET) as first‐line investigation for the diagnosis and localization of non‐metastatic and metastatic phaeochromocytoma (PHEO)
Author(s) -
Timmers Henri J. L. M.,
Eisenhofer Graeme,
Carrasquillo Jorge A.,
Chen Clara C.,
Whatley Millie,
Ling Alexander,
Adams Karen T.,
Pacak Karel
Publication year - 2009
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2008.03496.x
Subject(s) - medicine , metanephrines , pheochromocytoma , nuclear medicine , positron emission tomography , magnetic resonance imaging , radiology , scintigraphy , paraganglioma
Summary Objective Imaging modalities available for the localization of phaeochromocytoma (PHEO) include computed tomography (CT), magnetic resonance imaging (MRI), [ 123 I]‐ or [ 131 I]‐labelled metaiodobenzylguanidine ( 123/131 I‐MIBG) scintigraphy and 6‐[ 18 F]‐fluorodopamine ( 18 F‐FDA) positron emission tomography (PET). Our aim was to investigate the yield of 18 F‐FDA PET vs. biochemical testing and other imaging techniques to establish the diagnosis and location of PHEO. Patients and measurements The study included 99 consecutive patients (35 Males, 64 Females, mean ± SD age 46·4 ± 13·4 years), who underwent 18 F‐FDA PET, biochemical testing (plasma catecholamines and free metanephrines) and CT and/or MRI. The majority (78%) also underwent 123/131 I‐MIBG. Results In total 26 patients had non‐metastatic PHEO, 34 patients had metastatic PHEO, and PHEO was ruled out in 39 patients. Investigations to rule out or confirm PHEO yielded the following sensitivity/specificity: plasma metanephrines 97/95%, 18 F‐FDA 92/90%, 123 I‐MIBG 83/100%, 123/131 I‐MIBG 70/100%, CT 100/41%, MRI 98/60%. Sensitivities for localizing non‐metastatic PHEO on a per‐lesion base were: CT 97%, MRI 92%, 18 F‐FDA 78%, 123 I‐MIBG 78% and 123/131 I‐MIBG 76%. Sensitivities for detecting metastases on a per‐patient base were: CT and MRI 100%, 18 F‐FDA 97%, 123 I‐MIBG 85% and 123/131 I‐MIBG 65%. Conclusion For tumour localization, 18 F‐FDA PET and 123/131 I‐MIBG scintigraphy perform equally well in patients with non‐metastatic PHEO, but metastases are better detected by 18 F‐FDA PET than by 123/131 I‐MIBG.