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Chromogranin A Assay and ¹³¹I-MIBG Scintigraphy for Diagnosis and Follow-Up of Pheochromocytoma

Departments of Nuclear Medicine, Endocrine Surgery, and Endocrinology, Center Hospitalier Universitaire de Lille, Lille, France

We assessed the performance of a new serum chromogranin A (CgA) assay in combination with the results of ¹³¹I-metaiodobenzylguanidine (MIBG) scintigraphy for diagnosis and follow-up in 89 patients with clinical findings suggestive of pheochromocytoma. Methods: The study population consisted of 41 patients with proven pheochromocytoma and 48 patients with refuted pheochromocytoma. Eighty-seven scintigraphy examinations were performed, 52 in patients with proven pheochromocytoma (39 before surgery and 13 after surgery) and 35 in patients with refuted pheochromocytoma. Results: The sensitivity of the CgA level was 90.2%, and the specificity was 99.0% and 92.3% in the control and refuted pheochromocytoma groups, respectively. A significant relationship was seen between serum levels of CgA and tumor mass (r = 0.70; P < 10^-5). The postoperative CgA level was an early and accurate predictor of curative surgery or relapse. The concordance between CgA levels and scintigraphic data was 90.8%. Conclusion: Serum CgA level is an effective marker of pheochromocytoma. Increased levels strongly correlate with tumor mass; therefore, small tumors may go undetected. The concordance between CgA level and the results of ¹³¹I-MIBG scintigraphy is high. A CgA level in the reference range is highly predictive of normal scintigraphy findings.

Key Words: pheochromocytoma • ¹³¹I-metaiodobenzylguanidine scan • chromogranin A assay

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