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EANM 2012 guidelines for radionuclide imaging of phaeochromocytoma and paraganglioma

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Radionuclide imaging of phaeochromocytomas (PCCs) and paragangliomas (PGLs) involves various functional imaging techniques and approaches for accurate diagnosis, staging and tumour characterization. The purpose of the present guidelines is to assist nuclear medicine practitioners in performing, interpreting and reporting the results of the currently available SPECT and PET imaging approaches. These guidelines are intended to present information specifically adapted to European practice.

Methods

Guidelines from related fields, issued by the European Association of Nuclear Medicine and the Society of Nuclear Medicine, were taken into consideration and are partially integrated within this text. The same was applied to the relevant literature, and the final result was discussed with leading experts involved in the management of patients with PCC/PGL. The information provided should be viewed in the context of local conditions, laws and regulations.

Conclusion

Although several radionuclide imaging modalities are considered herein, considerable focus is given to PET imaging which offers high sensitivity targeted molecular imaging approaches.

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References

  1. Taieb D, Neumann H, Rubello D, Al-Nahhas A, Guillet B, Hindie E. Modern nuclear imaging for paragangliomas: beyond SPECT. J Nucl Med. 2012;53:264–74.

    Article  PubMed  CAS  Google Scholar 

  2. Karasek D, Shah U, Frysak Z, Stratakis C, Pacak K. An update on the genetics of pheochromocytoma. J Hum Hypertens. 2012

  3. Rutgers M, Tytgat GA, Verwijs-Janssen M, Buitenhuis C, Voute PA, Smets LA. Uptake of the neuron-blocking agent meta-iodobenzylguanidine and serotonin by human platelets and neuro-adrenergic tumour cells. Int J Cancer. 1993;54:290–5.

    Article  PubMed  CAS  Google Scholar 

  4. Jaques Jr S, Tobes MC, Sisson JC. Sodium dependency of uptake of norepinephrine and m-iodobenzylguanidine into cultured human pheochromocytoma cells: evidence for uptake-one. Cancer Res. 1987;47:3920–8.

    PubMed  Google Scholar 

  5. Bomanji J, Levison DA, Flatman WD, Horne T, Bouloux PM, Ross G, et al. Uptake of iodine-123 MIBG by pheochromocytomas, paragangliomas, and neuroblastomas: a histopathological comparison. J Nucl Med. 1987;28:973–8.

    PubMed  CAS  Google Scholar 

  6. Sinclair AJ, Bomanji J, Harris P, Ross G, Besser GM, Britton KE. Pre- and post-treatment distribution pattern of 123I-MIBG in patients with phaeochromocytomas and paragangliomas. Nucl Med Commun. 1989;10:567–76.

    Article  PubMed  CAS  Google Scholar 

  7. Solanki KK, Bomanji J, Moyes J, Mather SJ, Trainer PJ, Britton KE. A pharmacological guide to medicines which interfere with the biodistribution of radiolabelled meta-iodobenzylguanidine (MIBG). Nucl Med Commun. 1992;13:513–21.

    Article  PubMed  CAS  Google Scholar 

  8. Bombardieri E, Aktolun C, Baum RP, Bishof-Delaloye A, Buscombe J, Chatal JF, et al. 131I/123I-metaiodobenzylguanidine (MIBG) scintigraphy: procedure guidelines for tumour imaging. Eur J Nucl Med Mol Imaging. 2003;30:BP132–9.

    PubMed  Google Scholar 

  9. Bombardieri E, Giammarile F, Aktolun C, Baum RP, Bischof Delaloye A, Maffioli L, et al. 131I/123I-metaiodobenzylguanidine (mIBG) scintigraphy: procedure guidelines for tumour imaging. Eur J Nucl Med Mol Imaging. 2010;37:2436–46.

    Article  PubMed  Google Scholar 

  10. Khafagi FA, Shapiro B, Fig LM, Mallette S, Sisson JC. Labetalol reduces iodine-131 MIBG uptake by pheochromocytoma and normal tissues. J Nucl Med. 1989;30:481–9.

    PubMed  CAS  Google Scholar 

  11. Apeldoorn L, Voerman HJ, Hoefnagel CA. Interference of MIBG uptake by medication: a case report. Neth J Med. 1995;46:239–43.

    Article  PubMed  CAS  Google Scholar 

  12. Estorch M, Carrio I, Mena E, Flotats A, Camacho V, Fuertes J, et al. Challenging the neuronal MIBG uptake by pharmacological intervention: effect of a single dose of oral amitriptyline on regional cardiac MIBG uptake. Eur J Nucl Med Mol Imaging. 2004;31:1575–80.

    Article  PubMed  CAS  Google Scholar 

  13. Zaplatnikov K, Menzel C, Dobert N, Hamscho N, Kranert WT, Gotthard M, et al. Case report: drug interference with MIBG uptake in a patient with metastatic paraganglioma. Br J Radiol. 2004;77:525–7.

    Article  PubMed  CAS  Google Scholar 

  14. Blake GM, Lewington VJ, Fleming JS, Zivanovic MA, Ackery DM. Modification by nifedipine of 131I-meta-iodobenzylguanidine kinetics in malignant phaeochromocytoma. Eur J Nucl Med. 1988;14:345–8.

    Article  PubMed  CAS  Google Scholar 

  15. Taniguchi K, Ishizu K, Torizuka T, Hasegawa S, Okawada T, Ozawa T, et al. Metastases of predominantly dopamine-secreting phaeochromocytoma that did not accumulate meta-iodobenzylguanidine: imaging with whole body positron emission tomography using 18F-labelled deoxyglucose. Eur J Surg. 2001;167:866–70.

    Article  PubMed  CAS  Google Scholar 

  16. Van Der Horst-Schrivers AN, Osinga TE, Kema IP, Van Der Laan BF, Dullaart RP. Dopamine excess in patients with head and neck paragangliomas. Anticancer Res. 2010;30:5153–8.

    Google Scholar 

  17. van Gelder T, Verhoeven GT, de Jong P, Oei HY, Krenning EP, Vuzevski VD, et al. Dopamine-producing paraganglioma not visualized by iodine-123-MIBG scintigraphy. J Nucl Med. 1995;36:620–2.

    PubMed  Google Scholar 

  18. Hall FT, Perez-Ordonez B, Mackenzie RG, Gilbert RW. Does catecholamine secretion from head and neck paragangliomas respond to radiotherapy? Case report and literature review. Skull Base. 2003;13:229–34.

    Article  PubMed  Google Scholar 

  19. Tobes MC, Fig LM, Carey J, Geatti O, Sisson JC, Shapiro B. Alterations of iodine-131 MIBG biodistribution in an anephric patient: comparison to normal and impaired renal function. J Nucl Med. 1989;30:1476–82.

    PubMed  CAS  Google Scholar 

  20. Ilias I, Chen CC, Carrasquillo JA, Whatley M, Ling A, Lazurova I, et al. Comparison of 6-18F-fluorodopamine PET with 123I-metaiodobenzylguanidine and 111In-pentetreotide scintigraphy in localization of nonmetastatic and metastatic pheochromocytoma. J Nucl Med. 2008;49:1613–9.

    Article  PubMed  Google Scholar 

  21. Timmers HJ, Eisenhofer G, Carrasquillo JA, Chen CC, Whatley M, Ling A, et al. Use of 6-[18F]-fluorodopamine positron emission tomography (PET) as first-line investigation for the diagnosis and localization of non-metastatic and metastatic phaeochromocytoma (PHEO). Clin Endocrinol (Oxf). 2009;71:11–7.

    Article  Google Scholar 

  22. Timmers HJ, Chen CC, Carrasquillo JA, Whatley M, Ling A, Havekes B, et al. Comparison of 18F-fluoro-L-DOPA, 18F-fluoro-deoxyglucose, and 18F-fluorodopamine PET and 123I-MIBG scintigraphy in the localization of pheochromocytoma and paraganglioma. J Clin Endocrinol Metab. 2009;94:4757–67.

    Article  PubMed  CAS  Google Scholar 

  23. Fiebrich HB, Brouwers AH, Kerstens MN, Pijl ME, Kema IP, de Jong JR, et al. 6-[F-18]Fluoro-L-dihydroxyphenylalanine positron emission tomography is superior to conventional imaging with (123)I-metaiodobenzylguanidine scintigraphy, computer tomography, and magnetic resonance imaging in localizing tumors causing catecholamine excess. J Clin Endocrinol Metab. 2009;94:3922–30.

    Article  PubMed  CAS  Google Scholar 

  24. Fonte JS, Robles JF, Chen CC, Reynolds J, Whatley M, Ling A, et al. False-negative 123I-MIBG SPECT is most commonly found in SDHB-related pheochromocytoma or paraganglioma with high frequency to develop metastatic disease. Endocr Relat Cancer. 2012;19:83–93.

    Article  PubMed  CAS  Google Scholar 

  25. Kaji P, Carrasquillo JA, Linehan WM, Chen CC, Eisenhofer G, Pinto PA, et al. The role of 6-[18F]fluorodopamine positron emission tomography in the localization of adrenal pheochromocytoma associated with von Hippel-Lindau syndrome. Eur J Endocrinol. 2007;156:483–7.

    Article  PubMed  CAS  Google Scholar 

  26. Hoegerle S, Nitzsche E, Altehoefer C, Ghanem N, Manz T, Brink I, et al. Pheochromocytomas: detection with 18F DOPA whole body PET – initial results. Radiology. 2002;222:507–12.

    Article  PubMed  Google Scholar 

  27. Krenning EP, Bakker WH, Kooij PP, Breeman WA, Oei HY, de Jong M, et al. Somatostatin receptor scintigraphy with indium-111-DTPA-D-Phe-1-octreotide in man: metabolism, dosimetry and comparison with iodine-123-Tyr-3-octreotide. J Nucl Med. 1992;33:652–8.

    PubMed  CAS  Google Scholar 

  28. Bombardieri E, Ambrosini V, Aktolun C, Baum RP, Bishof-Delaloye A, Del Vecchio S, et al. 111In-pentetreotide scintigraphy: procedure guidelines for tumour imaging. Eur J Nucl Med Mol Imaging. 2010;37:1441–8.

    Article  PubMed  Google Scholar 

  29. Kwekkeboom DJ, Kooij PP, Bakker WH, Macke HR, Krenning EP. Comparison of 111In-DOTA-Tyr3-octreotide and 111In-DTPA-octreotide in the same patients: biodistribution, kinetics, organ and tumor uptake. J Nucl Med. 1999;40:762–7.

    PubMed  CAS  Google Scholar 

  30. Stabin MG, Kooij PP, Bakker WH, Inoue T, Endo K, Coveney J, et al. Radiation dosimetry for indium-111-pentetreotide. J Nucl Med. 1997;38:1919–22.

    PubMed  CAS  Google Scholar 

  31. Bombardieri E, Aktolun C, Baum RP, Bishof-Delaloye A, Buscombe J, Chatal JF, et al. 111In-pentetreotide scintigraphy: procedure guidelines for tumour imaging. Eur J Nucl Med Mol Imaging. 2003;30:BP140–7.

    PubMed  Google Scholar 

  32. Balon HR. Updated practice guideline for somatostatin receptor scintigraphy. J Nucl Med. 2011;52:1838.

    Article  PubMed  Google Scholar 

  33. Balon HR, Brown TL, Goldsmith SJ, Silberstein EB, Krenning EP, Lang O, et al. The SNM practice guideline for somatostatin receptor scintigraphy 2.0. J Nucl Med Technol. 2011;39:317–24.

    Article  PubMed  Google Scholar 

  34. Bustillo A, Telischi F, Weed D, Civantos F, Angeli S, Serafini A, et al. Octreotide scintigraphy in the head and neck. Laryngoscope. 2004;114:434–40.

    Article  PubMed  CAS  Google Scholar 

  35. Duet M, Sauvaget E, Petelle B, Rizzo N, Guichard JP, Wassef M, et al. Clinical impact of somatostatin receptor scintigraphy in the management of paragangliomas of the head and neck. J Nucl Med. 2003;44:1767–74.

    PubMed  Google Scholar 

  36. Koopmans KP, Jager PL, Kema IP, Kerstens MN, Albers F, Dullaart RP. 111In-octreotide is superior to 123I-metaiodobenzylguanidine for scintigraphic detection of head and neck paragangliomas. J Nucl Med. 2008;49:1232–7.

    Article  PubMed  Google Scholar 

  37. Muros MA, Llamas-Elvira JM, Rodriguez A, Ramirez A, Gomez M, Arraez MA, et al. 111In-pentetreotide scintigraphy is superior to 123I-MIBG scintigraphy in the diagnosis and location of chemodectoma. Nucl Med Commun. 1998;19:735–42.

    Article  PubMed  CAS  Google Scholar 

  38. Schmidt M, Fischer E, Dietlein M, Michel O, Weber K, Moka D, et al. Clinical value of somatostatin receptor imaging in patients with suspected head and neck paragangliomas. Eur J Nucl Med Mol Imaging. 2002;29:1571–80.

    Article  PubMed  CAS  Google Scholar 

  39. Telischi FF, Bustillo A, Whiteman ML, Serafini AN, Reisberg MJ, Gomez-Marin O, et al. Octreotide scintigraphy for the detection of paragangliomas. Otolaryngol Head Neck Surg. 2000;122:358–62.

    Article  PubMed  CAS  Google Scholar 

  40. Charrier N, Deveze A, Fakhry N, Sebag F, Morange I, Gaborit B, et al. Comparison of [111In]pentetreotide-SPECT and [18F]FDOPA-PET in the localization of extra-adrenal paragangliomas: the case for a patient-tailored use of nuclear imaging modalities. Clin Endocrinol (Oxf). 2011;74:21–9.

    Article  CAS  Google Scholar 

  41. Kaltsas GA, Mukherjee JJ, Grossman AB. The value of radiolabelled MIBG and octreotide in the diagnosis and management of neuroendocrine tumours. Ann Oncol. 2001;12 Suppl 2:S47–50.

    Article  PubMed  Google Scholar 

  42. van der Harst E, de Herder WW, Bruining HA, Bonjer HJ, de Krijger RR, Lamberts SW, et al. [(123)I]metaiodobenzylguanidine and [(111)In]octreotide uptake in benign and malignant pheochromocytomas. J Clin Endocrinol Metab. 2001;86:685–93.

    Article  PubMed  Google Scholar 

  43. Tenenbaum F, Lumbroso J, Schlumberger M, Mure A, Plouin PF, Caillou B, et al. Comparison of radiolabeled octreotide and meta-iodobenzylguanidine (MIBG) scintigraphy in malignant pheochromocytoma. J Nucl Med. 1995;36:1–6.

    PubMed  CAS  Google Scholar 

  44. Wild D, Macke HR, Waser B, Reubi JC, Ginj M, Rasch H, et al. 68Ga-DOTANOC: a first compound for PET imaging with high affinity for somatostatin receptor subtypes 2 and 5. Eur J Nucl Med Mol Imaging. 2005;32:724.

    Article  PubMed  Google Scholar 

  45. Wild D, Schmitt JS, Ginj M, Macke HR, Bernard BF, Krenning E, et al. DOTA-NOC, a high-affinity ligand of somatostatin receptor subtypes 2, 3 and 5 for labelling with various radiometals. Eur J Nucl Med Mol Imaging. 2003;30:1338–47.

    Article  PubMed  CAS  Google Scholar 

  46. Reubi JC, Schar JC, Waser B, Wenger S, Heppeler A, Schmitt JS, et al. Affinity profiles for human somatostatin receptor subtypes SST1-SST5 of somatostatin radiotracers selected for scintigraphic and radiotherapeutic use. Eur J Nucl Med. 2000;27:273–82.

    Article  PubMed  CAS  Google Scholar 

  47. Virgolini I, Ambrosini V, Bomanji JB, Baum RP, Fanti S, Gabriel M, et al. Procedure guidelines for PET/CT tumour imaging with 68Ga-DOTA-conjugated peptides: 68Ga-DOTA-TOC, 68Ga-DOTA-NOC, 68Ga-DOTA-TATE. Eur J Nucl Med Mol Imaging. 2010;37:2004–10.

    Article  PubMed  Google Scholar 

  48. Velikyan I, Sundin A, Eriksson B, Lundqvist H, Sorensen J, Bergstrom M, et al. In vivo binding of [68Ga]-DOTATOC to somatostatin receptors in neuroendocrine tumours – impact of peptide mass. Nucl Med Biol. 2010;37:265–75.

    Article  PubMed  CAS  Google Scholar 

  49. Castellucci P, Pou Ucha J, Fuccio C, Rubello D, Ambrosini V, Montini GC, et al. Incidence of increased 68Ga-DOTANOC uptake in the pancreatic head in a large series of extrapancreatic NET patients studied with sequential PET/CT. J Nucl Med. 2011;52:886–90.

    Article  PubMed  Google Scholar 

  50. Fanti S, Ambrosini V, Tomassetti P, Castellucci P, Montini G, Allegri V, et al. Evaluation of unusual neuroendocrine tumours by means of 68Ga-DOTA-NOC PET. Biomed Pharmacother. 2008;62:667–71.

    Article  PubMed  CAS  Google Scholar 

  51. Naji M, Zhao C, Welsh SJ, Meades R, Win Z, Ferrarese A, et al. 68Ga-DOTA-TATE PET vs. 123I-MIBG in identifying malignant neural crest tumours. Mol Imaging Biol. 2011;13:769–75.

    Article  PubMed  Google Scholar 

  52. Win Z, Rahman L, Murrell J, Todd J, Al-Nahhas A. The possible role of 68Ga-DOTATATE PET in malignant abdominal paraganglioma. Eur J Nucl Med Mol Imaging. 2006;33:506.

    Article  PubMed  Google Scholar 

  53. Naji M, Al-Nahhas A. (68)Ga-labelled peptides in the management of neuroectodermal tumours. Eur J Nucl Med Mol Imaging. 2012;39 Suppl 1:61–7.

    Article  CAS  Google Scholar 

  54. Win Z, Al-Nahhas A, Towey D, Todd JF, Rubello D, Lewington V, et al. 68Ga-DOTATATE PET in neuroectodermal tumours: first experience. Nucl Med Commun. 2007;28:359–63.

    Article  PubMed  Google Scholar 

  55. Grassi I, Nanni C, Vicennati V, Castellucci P, Allegri V, Montini GC, et al. I-123 MIBG scintigraphy and 68Ga-DOTANOC PET/CT negative but F-18 DOPA PET/CT positive pheochromocytoma: a case report. Clin Nucl Med. 2011;36:124–6.

    Article  PubMed  Google Scholar 

  56. Naswa N, Sharma P, Nazar AH, Agarwal KK, Kumar R, Ammini AC, et al. Prospective evaluation of 68Ga-DOTA-NOC PET-CT in phaeochromocytoma and paraganglioma: preliminary results from a single centre study. Eur Radiol. 2012;22:710–9.

    Article  PubMed  Google Scholar 

  57. Hentschel M, Rottenburger C, Boedeker CC, Neumann HP, Brink I. Is there an optimal scan time for 6-[F-18]fluoro-L-DOPA PET in pheochromocytomas and paragangliomas? Clin Nucl Med. 2012;37:e24–9.

    Article  PubMed  Google Scholar 

  58. Timmers HJ, Hadi M, Carrasquillo JA, Chen CC, Martiniova L, Whatley M, et al. The effects of carbidopa on uptake of 6-18F-Fluoro-L-DOPA in PET of pheochromocytoma and extraadrenal abdominal paraganglioma. J Nucl Med. 2007;48:1599–606.

    Article  PubMed  CAS  Google Scholar 

  59. Luxen A, Perlmutter M, Bida GT, Van Moffaert G, Cook JS, Satyamurthy N, et al. Remote, semiautomated production of 6-[18F]fluoro-L-dopa for human studies with PET. Int J Rad Appl Instrum A. 1990;41:275–81.

    Article  PubMed  CAS  Google Scholar 

  60. Namavari M, Bishop A, Satyamurthy N, Bida G, Barrio JR. Regioselective radiofluorodestannylation with [18F]F2 and [18F]CH3COOF: a high yield synthesis of 6-[18F]Fluoro-L-dopa. Int J Rad Appl Instrum A. 1992;43:989–96.

    Article  PubMed  CAS  Google Scholar 

  61. Vernaleken I, Kumakura Y, Cumming P, Buchholz HG, Siessmeier T, Stoeter P, et al. Modulation of [18F]fluorodopa (FDOPA) kinetics in the brain of healthy volunteers after acute haloperidol challenge. Neuroimage. 2006;30:1332–9.

    Article  PubMed  Google Scholar 

  62. Garnett S, Firnau G, Nahmias C, Chirakal R. Striatal dopamine metabolism in living monkeys examined by positron emission tomography. Brain Res. 1983;280:169–71.

    Article  PubMed  CAS  Google Scholar 

  63. Brown WD, Oakes TR, DeJesus OT, Taylor MD, Roberts AD, Nickles RJ, et al. Fluorine-18-fluoro-L-DOPA dosimetry with carbidopa pretreatment. J Nucl Med. 1998;39:1884–91.

    PubMed  CAS  Google Scholar 

  64. Harvey J, Firnau G, Garnett ES. Estimation of the radiation dose in man due to 6-[18F]fluoro-L-dopa. J Nucl Med. 1985;26:931–5.

    PubMed  CAS  Google Scholar 

  65. Dhawan V, Belakhlef A, Robeson W, Ishikawa T, Margouleff C, Takikawa S, et al. Bladder wall radiation dose in humans from fluorine-18-FDOPA. J Nucl Med. 1996;37:1850–2.

    PubMed  CAS  Google Scholar 

  66. Beheshti M, Pocher S, Vali R, Waldenberger P, Broinger G, Nader M, et al. The value of 18F-DOPA PET-CT in patients with medullary thyroid carcinoma: comparison with 18F-FDG PET-CT. Eur Radiol. 2009;19:1425–34.

    Article  PubMed  Google Scholar 

  67. Soussan M, Nataf V, Kerrou K, Grahek D, Pascal O, Talbot JN, et al. Added value of early 18F-FDOPA PET/CT acquisition time in medullary thyroid cancer. Nucl Med Commun. 2012;33:775–9.

    Article  PubMed  Google Scholar 

  68. Treglia G, Cocciolillo F, de Waure C, Di Nardo F, Gualano MR, Castaldi P, et al. Diagnostic performance of 18F-dihydroxyphenylalanine positron emission tomography in patients with paraganglioma: a meta-analysis. Eur J Nucl Med Mol Imaging. 2012;39:1144–53.

    Article  PubMed  Google Scholar 

  69. Mackenzie IS, Gurnell M, Balan KK, Simpson H, Chatterjee K, Brown MJ. The use of 18-fluoro-dihydroxyphenylalanine and 18-fluorodeoxyglucose positron emission tomography scanning in the assessment of metaiodobenzylguanidine-negative phaeochromocytoma. Eur J Endocrinol. 2007;157:533–7.

    Article  PubMed  CAS  Google Scholar 

  70. Imani F, Agopian VG, Auerbach MS, Walter MA, Imani F, Benz MR, et al. 18F-FDOPA PET and PET/CT accurately localize pheochromocytomas. J Nucl Med. 2009;50:513–9.

    Article  PubMed  Google Scholar 

  71. Kauhanen S, Seppanen M, Ovaska J, Minn H, Bergman J, Korsoff P, et al. The clinical value of [18F]fluoro-dihydroxyphenylalanine positron emission tomography in primary diagnosis, staging, and restaging of neuroendocrine tumors. Endocr Relat Cancer. 2009;16:255–65.

    Article  PubMed  CAS  Google Scholar 

  72. Luster M, Karges W, Zeich K, Pauls S, Verburg FA, Dralle H, et al. Clinical value of 18F-fluorodihydroxyphenylalanine positron emission tomography/computed tomography (18F-DOPA PET/CT) for detecting pheochromocytoma. Eur J Nucl Med Mol Imaging. 2010;37:484–93.

    Article  PubMed  Google Scholar 

  73. Fottner C, Helisch A, Anlauf M, Rossmann H, Musholt TJ, Kreft A, et al. 6-18F-fluoro-L-dihydroxyphenylalanine positron emission tomography is superior to 123I-metaiodobenzyl-guanidine scintigraphy in the detection of extraadrenal and hereditary pheochromocytomas and paragangliomas: correlation with vesicular monoamine transporter expression. J Clin Endocrinol Metab. 2010;95:2800–10.

    Article  PubMed  CAS  Google Scholar 

  74. Rufini V, Treglia G, Castaldi P, Perotti G, Calcagni ML, Corsello SM, et al. Comparison of 123I-MIBG SPECT-CT and 18F-DOPA PET-CT in the evaluation of patients with known or suspected recurrent paraganglioma. Nucl Med Commun. 2011;32:575–82.

    Article  PubMed  Google Scholar 

  75. Leboulleux S, Deandreis D, Escourrou C, Al Ghuzlan A, Bidault F, Auperin A, et al. Fluorodesoxyglucose uptake in the remaining adrenal glands during the follow-up of patients with adrenocortical carcinoma: do not consider it as malignancy. Eur J Endocrinol. 2011;164:89–94.

    Article  PubMed  CAS  Google Scholar 

  76. Hoegerle S, Ghanem N, Altehoefer C, Schipper J, Brink I, Moser E, et al. 18F-DOPA positron emission tomography for the detection of glomus tumours. Eur J Nucl Med Mol Imaging. 2003;30:689–94.

    Article  PubMed  CAS  Google Scholar 

  77. King KS, Chen CC, Alexopoulos DK, Whatley MA, Reynolds JC, Patronas N, et al. Functional imaging of SDHx-related head and neck paragangliomas: comparison of 18F-fluorodihydroxyphenylalanine, 18F-fluorodopamine, 18F-fluoro-2-deoxy-D-glucose PET, 123I-metaiodobenzylguanidine scintigraphy, and 111In-pentetreotide scintigraphy. J Clin Endocrinol Metab. 2011;96:2779–85.

    Article  PubMed  CAS  Google Scholar 

  78. King KS, Whatley MA, Alexopoulos DK, Reynolds JC, Chen CC, Mattox DE, et al. The use of functional imaging in a patient with head and neck paragangliomas. J Clin Endocrinol Metab. 2010;95:481–2.

    Article  PubMed  CAS  Google Scholar 

  79. Weisbrod AB, Kitano M, Gesuwan K, Millo C, Herscovitch P, Nilubol N, et al. Clinical utility of functional imaging with 18F-FDOPA in Von Hippel-Lindau syndrome. J Clin Endocrinol Metab. 2012;97:E613–7.

    Article  PubMed  CAS  Google Scholar 

  80. Taieb D, Tessonnier L, Sebag F, Niccoli-Sire P, Morange I, Colavolpe C, et al. The role of 18F-FDOPA and 18F-FDG-PET in the management of malignant and multifocal phaeochromocytomas. Clin Endocrinol (Oxf). 2008;69:580–6.

    Article  CAS  Google Scholar 

  81. Favier J, Briere JJ, Burnichon N, Riviere J, Vescovo L, Benit P, et al. The Warburg effect is genetically determined in inherited pheochromocytomas. PLoS One. 2009;4:e7094.

    Article  PubMed  CAS  Google Scholar 

  82. Lopez-Jimenez E, Gomez-Lopez G, Leandro-Garcia LJ, Munoz I, Schiavi F, Montero-Conde C, et al. Research resource: transcriptional profiling reveals different pseudohypoxic signatures in SDHB and VHL-related pheochromocytomas. Mol Endocrinol. 2010;24:2382–91.

    Article  PubMed  CAS  Google Scholar 

  83. Burnichon N, Vescovo L, Amar L, Libe R, de Reynies A, Venisse A, et al. Integrative genomic analysis reveals somatic mutations in pheochromocytoma and paraganglioma. Hum Mol Genet. 2011;20:3974–85.

    Article  PubMed  CAS  Google Scholar 

  84. Pollard PJ, El-Bahrawy M, Poulsom R, Elia G, Killick P, Kelly G, et al. Expression of HIF-1alpha, HIF-2alpha (EPAS1), and their target genes in paraganglioma and pheochromocytoma with VHL and SDH mutations. J Clin Endocrinol Metab. 2006;91:4593–8.

    Article  PubMed  CAS  Google Scholar 

  85. Span PN, Rao JU, Oude Ophuis SB, Lenders JW, Sweep FC, Wesseling P, et al. Overexpression of the natural antisense hypoxia-inducible factor-1alpha transcript is associated with malignant pheochromocytoma/paraganglioma. Endocr Relat Cancer. 2011;18:323–31.

    Article  PubMed  CAS  Google Scholar 

  86. Taieb D, Sebag F, Barlier A, Tessonnier L, Palazzo FF, Morange I, et al. 18F-FDG avidity of pheochromocytomas and paragangliomas: a new molecular imaging signature? J Nucl Med. 2009;50:711–7.

    Article  PubMed  CAS  Google Scholar 

  87. Timmers HJ, Chen CC, Carrasquillo JA, Whatley M, Ling A, Eisenhofer G, et al. Staging and functional characterization of pheochromocytoma and paraganglioma by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography. J Natl Cancer Inst. 2012;104:700–8.

    Article  PubMed  CAS  Google Scholar 

  88. Boellaard R, O’Doherty MJ, Weber WA, Mottaghy FM, Lonsdale MN, Stroobants SG, et al. FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0. Eur J Nucl Med Mol Imaging. 2010;37:181–200.

    Article  PubMed  Google Scholar 

  89. Timmers HJ, Kozupa A, Chen CC, Carrasquillo JA, Ling A, Eisenhofer G, et al. Superiority of fluorodeoxyglucose positron emission tomography to other functional imaging techniques in the evaluation of metastatic SDHB-associated pheochromocytoma and paraganglioma. J Clin Oncol. 2007;25:2262–9.

    Article  PubMed  Google Scholar 

  90. Gabriel M, Decristoforo C, Donnemiller E, Ulmer H, Watfah Rychlinski C, Mather SJ, et al. An intrapatient comparison of 99mTc-EDDA/HYNIC-TOC with 111In-DTPA-octreotide for diagnosis of somatostatin receptor-expressing tumors. J Nucl Med. 2003;44:708–16.

    PubMed  CAS  Google Scholar 

  91. Grimes J, Celler A, Birkenfeld B, Shcherbinin S, Listewnik MH, Piwowarska-Bilska H, et al. Patient-specific radiation dosimetry of 99mTc-HYNIC-Tyr3-octreotide in neuroendocrine tumors. J Nucl Med. 2011;52:1474–81.

    Article  PubMed  CAS  Google Scholar 

  92. Pacak K, Eisenhofer G, Carrasquillo JA, Chen CC, Li ST, Goldstein DS. 6-[18F]fluorodopamine positron emission tomographic (PET) scanning for diagnostic localization of pheochromocytoma. Hypertension. 2001;38:6–8.

    Article  PubMed  CAS  Google Scholar 

  93. Ilias I, Yu J, Carrasquillo JA, Chen CC, Eisenhofer G, Whatley M, et al. Superiority of 6-[18F]-fluorodopamine positron emission tomography versus [131I]-metaiodobenzylguanidine scintigraphy in the localization of metastatic pheochromocytoma. J Clin Endocrinol Metab. 2003;88:4083–7.

    Article  PubMed  CAS  Google Scholar 

  94. Mann GN, Link JM, Pham P, Pickett CA, Byrd DR, Kinahan PE, et al. [11C]Metahydroxyephedrine and [18F]fluorodeoxyglucose positron emission tomography improve clinical decision making in suspected pheochromocytoma. Ann Surg Oncol. 2006;13:187–97.

    Article  PubMed  Google Scholar 

  95. Shulkin BL, Wieland DM, Schwaiger M, Thompson NW, Francis IR, Haka MS, et al. PET scanning with hydroxyephedrine: an approach to the localization of pheochromocytoma. J Nucl Med. 1992;33:1125–31.

    PubMed  CAS  Google Scholar 

  96. Trampal C, Engler H, Juhlin C, Bergstrom M, Langstrom B. Pheochromocytomas: detection with 11C hydroxyephedrine PET. Radiology. 2004;230:423–8.

    Article  PubMed  Google Scholar 

  97. Franzius C, Hermann K, Weckesser M, Kopka K, Juergens KU, Vormoor J, et al. Whole-body PET/CT with 11C-meta-hydroxyephedrine in tumors of the sympathetic nervous system: feasibility study and comparison with 123I-MIBG SPECT/CT. J Nucl Med. 2006;47:1635–42.

    PubMed  Google Scholar 

  98. Rahbar K, Kies P, Stegger L, Juergens KU, Weckesser M. Discrepancy between glucose metabolism and sympathetic nerve terminals in a patient with metastatic paraganglioma. Eur J Nucl Med Mol Imaging. 2008;35:687.

    Article  PubMed  Google Scholar 

  99. Loc’h C, Mardon K, Valette H, Brutesco C, Merlet P, Syrota A, et al. Preparation and pharmacological characterization of [76Br]-meta-bromobenzylguanidine ([76Br]MBBG). Nucl Med Biol. 1994;21:49–55.

    Article  PubMed  Google Scholar 

  100. Vaidyanathan G, Affleck DJ, Zalutsky MR. Validation of 4-[fluorine-18]fluoro-3-iodobenzylguanidine as a positron-emitting analog of MIBG. J Nucl Med. 1995;36:644–50.

    PubMed  CAS  Google Scholar 

  101. Yu M, Bozek J, Lamoy M, Guaraldi M, Silva P, Kagan M, et al. Evaluation of LMI1195, a novel 18F-labeled cardiac neuronal PET imaging agent, in cells and animal models. Circ Cardiovasc Imaging. 2011;4:435–43.

    Article  PubMed  Google Scholar 

  102. Martiniova L, Perera SM, Brouwers FM, Alesci S, Abu-Asab M, Marvelle AF, et al. Increased uptake of [123I]meta-iodobenzylguanidine, [18F]fluorodopamine, and [3H]norepinephrine in mouse pheochromocytoma cells and tumors after treatment with the histone deacetylase inhibitors. Endocr Relat Cancer. 2011;18:143–57.

    Article  PubMed  CAS  Google Scholar 

  103. Taieb D, Rubello D, Al-Nahhas A, Calzada M, Marzola MC, Hindie E. Modern PET imaging for paragangliomas: relation to genetic mutations. Eur J Surg Oncol. 2011;37:662–8.

    Article  PubMed  CAS  Google Scholar 

  104. Havekes B, King K, Lai EW, Romijn JA, Corssmit EP, Pacak K. New imaging approaches to phaeochromocytomas and paragangliomas. Clin Endocrinol (Oxf). 2010;72:137–45.

    Article  CAS  Google Scholar 

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Correspondence to David Taïeb or Domenico Rubello.

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Purpose

The purpose of these guidelines is to assist nuclear medicine practitioners in:

1. Understanding the role and challenges of radionuclide imaging of phaeochromocytomas/paragangliomas.

2. Providing practical information for performing different imaging procedures for these tumours.

3. Providing an algorithm for selecting the most appropriate imaging procedure in each specific clinical situation to localize and characterize these tumours.

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Taïeb, D., Timmers, H.J., Hindié, E. et al. EANM 2012 guidelines for radionuclide imaging of phaeochromocytoma and paraganglioma. Eur J Nucl Med Mol Imaging 39, 1977–1995 (2012). https://doi.org/10.1007/s00259-012-2215-8

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  • DOI: https://doi.org/10.1007/s00259-012-2215-8

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