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Imaging characterization of benign and malignant pheochromocytoma or paraganglioma: comparison between MIBG uptake and MR signal intensity ratio

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Abstract

Objective

We compared metaiodobenzylguanidine (MIBG) uptake and magnetic resonance (MR) signal intensity ratio in differentiating benign and malignant disease in patients with pheochromocytoma or paraganglioma.

Methods

Eighteen patients (9 men, mean age 37 ± 8 years) with pheochromocytoma or paraganglioma underwent MR imaging and iodine-131 MIBG scintigraphy. MR signal intensity ratio was measured on T1 and T2-weighted images using region of interest analysis and intensity ratio of MIBG uptake was calculated for each tumor lesion on 48 h images.

Results

A total of 28 tumor lesions was analyzed of which 12 were benign and 16 malignant. MIBG uptake intensity ratio was significantly higher in malignant lesions compared to benign (5.2 ± 2.4 and 2.9 ± 1.4, respectively, p < 0.01). On the contrary, no significant difference in tumor size and MR signal intensity ratio between malignant and benign tumor lesions was observed.

Conclusions

In patients with pheochromocytoma or paraganglioma, iodine-131 MIBG uptake is able to differentiate between benign and malignant disease, while MR imaging is not useful for this purpose. The higher MIBG uptake observed in malignant lesions could reflect major tumor storage of catecholamines compared to benign lesions.

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Authors and Affiliations

  1. Department of Biomorphological and Functional Sciences, University Federico II, Naples, Italy

    Simone Maurea, Alberto Cuocolo, Massimo Imbriaco, Mario Fusari & Marco Salvatore

  2. Institute of Biostructures and Bioimages, National Council of Research, Naples, Italy

    Simone Maurea, Alberto Cuocolo, Massimo Imbriaco, Teresa Pellegrino, Raffaele Liuzzi & Marco Salvatore

  3. SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy

    Renato Cuocolo

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  1. Simone Maurea
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  2. Alberto Cuocolo
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  3. Massimo Imbriaco
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  4. Teresa Pellegrino
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  6. Renato Cuocolo
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  7. Raffaele Liuzzi
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  8. Marco Salvatore
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Correspondence to Simone Maurea.

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Maurea, S., Cuocolo, A., Imbriaco, M. et al. Imaging characterization of benign and malignant pheochromocytoma or paraganglioma: comparison between MIBG uptake and MR signal intensity ratio. Ann Nucl Med 26, 670–675 (2012). https://doi.org/10.1007/s12149-012-0624-1

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  • DOI: https://doi.org/10.1007/s12149-012-0624-1

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