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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

View larger version (94K): [in this window] [in a new window]   FIGURE 1.  (A) Anterior (left) and posterior (right) whole-body images of 51-y-old woman with right adrenal tumor on CT, confirmed as pheochromocytoma at surgery. (B) Anterior (left) and posterior (right) whole-body images of 28-y-old woman with paraganglioma metastatic to bone.

View larger version (26K): [in this window] [in a new window]   FIGURE 2.  (A) Anterior (left) and posterior (right) whole-body 123I-MIBG images of 59-y-old man with remote history of neck paraganglioma excised at age 25. As part of routine follow-up, abdominal CT scan was acquired and showed no abnormalities. Increased uptake in right upper abdomen is apparent on posterior 123I-MIBG image (arrow). (B) Selected axial and coronal SPECT images demonstrate discrete increased uptake corresponding to abdominal finding on planar images. All 3 readers identified this uptake as in right adrenal gland, uptake that presumably reflected asymmetry in otherwise normal gland. Knowledge of history and CT findings might have altered readers' conclusion that uptake was pathologic.