RT Journal Article
SR Electronic
T1 Diagnostic Performance of <sup>124</sup>I-Metaiodobenzylguanidine PET/CT in Patients with Pheochromocytoma
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 869
OP 874
DO 10.2967/jnumed.121.262797
VO 63
IS 6
A1 Manuel Weber
A1 Jochen Schmitz
A1 Ines Maric
A1 Kim Pabst
A1 Lale Umutlu
A1 Martin Walz
A1 Ken Herrmann
A1 Christoph Rischpler
A1 Frank Weber
A1 Walter Jentzen
A1 Sarah Theurer
A1 Thorsten D. Poeppel
A1 Nicole Unger
A1 Wolfgang P. Fendler
YR 2022
UL http://jnm.snmjournals.org/content/63/6/869.abstract
AB 123/131I-metaiodobenzylguanidine (MIBG) scintigraphy has shown a high specificity for imaging pheochromocytoma and paraganglioma, but with low sensitivity because of low spatial resolution. 124I-MIBG PET may be able to overcome this limitation and improve the staging of patients with (suspected) pheochromocytoma. Methods: We analyzed the sensitivity, specificity, and positive and negative predictive values of 124I-MIBG PET in 43 consecutive patients with suspected (recurrence of) pheochromocytoma using histopathologic (n = 25) and clinical validation (n = 18) as the standard of truth. Furthermore, we compared the detection rate of 124I-MIBG PET versus contrast-enhanced (CE) CT on a per-patient and per-lesion basis in 13 additional patients with known metastatic malignant pheochromocytoma. Results: 124I-MIBG PET/CT was positive in 19 (44%) of 43 patients with suspected pheochromocytoma. The presence of pheochromocytoma was confirmed in 22 (51%) of 43. 124I-MIBG PET/CT sensitivity, specificity, and positive and negative predictive values were 86%, 100%, 100%, and 88%, respectively. 124I-MIBG PET was positive in 11 (85%) of 13 patients with malignant pheochromocytoma. Combined 124I-MIBG PET and CE CT detected 173 lesions, of which 166 (96%) and 118 (68%) were visible on 124I-MIBG PET and CE CT, respectively. Conclusion: 124I-MIBG PET detects pheochromocytoma with high accuracy at initial staging and a high detection rate at restaging. Future assessment of 124I-MIBG PET for treatment guidance, including personalized 131I-MIBG therapy, is warranted.