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This Article Figures Only Full Text Full Text (PDF) Supplemental Data All Versions of this Article: jnumed.108.058701v1 50/9/1448    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Related articles in JNM Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Wiseman, G. A. Articles by Jacobson, A. F. PubMed PubMed Citation Articles by Wiseman, G. A. Articles by Jacobson, A. F.

Usefulness of ¹²³I-MIBG Scintigraphy in the Evaluation of Patients with Known or Suspected Primary or Metastatic Pheochromocytoma or Paraganglioma: Results from a Prospective Multicenter Trial

¹ Department of Nuclear Medicine, Mayo Clinic, Rochester, Minnesota; ² Reproductive and Adult Endocrinology Program, National Institute of Child Health and Development, National Institutes of Health, Bethesda, Maryland; ³ Department of Pediatrics, University of Iowa, Iowa City, Iowa; ⁴ Department of Nuclear Medicine, Cleveland Clinic, Cleveland, Ohio; ⁵ Department of Nuclear Medicine, Cedars-Sinai Medical Center, Los Angeles, California; ⁶ Department of Radiology, University of Washington, Seattle, Washington; ⁷ Department of Nuclear Medicine, Mount Sinai Medical Center, New York, New York; ⁸ Department of Nuclear Medicine, University of Miami, Miami, Florida; ⁹ Department of Radiology, Piedmont Hospital, Atlanta, Georgia; and ¹⁰ Research and Development, GE Healthcare, Princeton, New Jersey

Correspondence: For correspondence or reprints contact: Arnold F. Jacobson, GE Healthcare Medical Diagnostics, 101 Carnegie Center, Princeton, NJ 08540. E-mail: arnold.jacobson{at}ge.com

Although ¹²³I-MIBG has been in clinical use for the imaging of pheochromocytoma for many years, a large multicenter evaluation of this agent has never been performed. The present study was designed to provide a prospective confirmation of the performance of ¹²³I-MIBG scintigraphy for the evaluation of patients with known or suspected primary or metastatic pheochromocytoma or paraganglioma. Methods: A total of 81 patients with a prior history of primary or metastatic pheochromocytoma or paraganglioma and 69 with suspected pheochromocytoma or paraganglioma based on symptoms of catecholamine excess, CT or MRI findings, or elevated catecholamine or metanephrine levels underwent whole-body planar and selected SPECT 24 h after the administration of ¹²³I-MIBG. Images were independently interpreted by 3 masked readers, with consensus requiring agreement of at least 2 readers. Final diagnoses were based on histopathology, correlative imaging, catecholamine or metanephrine measurements, and clinical follow-up. Results: Among 140 patients with definitive diagnoses (91, disease present; 49, disease absent), ¹²³I-MIBG planar scintigraphy had a sensitivity and specificity of 82%. For patients evaluated for suspected disease, sensitivity and specificity were 88% and 84%, respectively. For the subpopulations of adrenal (pheochromocytoma) and extraadrenal (paraganglioma) tumors, sensitivities were 88% and 67%, respectively. The addition of SPECT increased reader confidence but minimally affected sensitivity and specificity. Conclusion: This prospective study demonstrated a sensitivity of 82%–88% and specificity of 82%–84% for ¹²³I-MIBG imaging used in the diagnostic assessment of primary or metastatic pheochromocytoma or paraganglioma.

Key Words: ¹²³I-MIBG • scintigraphy • pheochromocytoma • paraganglioma • neuroendocrine tumors

COPYRIGHT © 2009 by the Society of Nuclear Medicine, Inc.

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