Superiority of Fluorodeoxyglucose Positron Emission Tomography to Other Functional Imaging Techniques in the Evaluation of Metastatic SDHB-Associated Pheochromocytoma and Paraganglioma

Abstract

With a sensitivity approaching 100%, [18F]FDG-PET is the preferred functional imaging modality for staging and treatment monitoring of SDHB-related metastatic PGL.

Role of 18F-FDG PET/CT, 123I-MIBG SPECT, and CT in Restaging Patients Affected by Malignant Pheochromocytoma

“…In all patients, we found a full correspondence between the number of lesions revealed by radiologic imaging (CT) and the pathological uptakes revealed by 18 F-FDG PET/CT. The majority of the ambiguous lesions revealed by CT were confirmed as positive on 18 F-FDG PET/CT; our findings are quite similar to what was observed in other studies about PH [7,8,13,14] confirming 18 F-FDG PET/CT accuracy even in restaging and follow-up. Other studies have also demonstrated that 18 F-FDG PET/CT is superior to 123 I-MIBG SPECT for evaluating treatment response, considering its more accurate spatial resolution and the possible presence of MIBG-confounding treatment [19,20].…”

“…The role of 18 F-FDG PET/CT in staging patients affected by PH is well established as these tumors have shown high glucose metabolism [9][10][11][12][13][14][15][16], although, unfortunately, a correlation between 18 F-FDG uptake and malignant potential or prognosis has never been demonstrated [7,8]. In particular, a study reported that there is not a significant difference between 18 F-FDG uptake in benign and malignant PH and that the uptake is not influenced by the secretory status [17].…”

“…In particular, a study reported that there is not a significant difference between 18 F-FDG uptake in benign and malignant PH and that the uptake is not influenced by the secretory status [17]. Other PET tracers have also been used, but none showed a better correlation between tumor activity and radiopharmaceutical uptake [9,12,14,18]. Data from related literature support two explanations: either that an early metabolic switch related to genetic defects occurs (the pseudohypoxia model) or that there is an adaptive response to hypoxia.…”

Treatment and outcome of metastatic paraganglioma of the spine

“…Compression fracture was common in our cases (66.7%). 18F-FDG-PET/CT has been used for diagnosis of various neoplasms including MPG [26]; it is also the most effective method to evaluate the metastasis of PGs [10]. There is no doubt that a preoperative biopsy can facilitate surgery protocol formulation, especially for the solitary lesion.…”

Case report: coexistence of pheochromocytoma and bilateral aldosterone-producing adenomas in a 36-year-old woman

“…The sensitivity of MIBG scintigraphy had reported to be 86-92% 1,11,12 and may show false negative in pheochromocytoma with small size or weak function. In this patient, the finding that noradrenaline and adrenaline concentrations in the right adrenal vein were 60 and 2.8 times higher compared with those in the left adrenal vein along with the MRI findings strongly suggested the presence of Abbreviations: Ad, adrenaline; DA, dopamine; Nad, noradrenaline; PAC, plasma aldosterone concentration.…”