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Current and Future Anatomical and Functional Imaging Approaches to Pheochromocytoma and Paraganglioma

2012; Thieme Medical Publishers (Germany); Volume: 44; Issue: 05 Linguagem: Inglês

10.1055/s-0031-1299712

1439-4286

H.J.L. Timmers, David Taïeb, Karel Pacák,

Hormonal Regulation and Hypertension

After establishing a biochemical diagnosis, pheochromocytomas and extra-adrenal paragangliomas (PPGLs) can be localized using different anatomical and functional imaging modalities. These include computed tomography, magnetic resonance imaging, single-photon emission computed tomography (SPECT) using 123 I-metaiodobenzylguanidine or 111 In-DTPA-pentetreotide, and positron emission tomography (PET) using 6-[ 18 F]-fluorodopamine ( 18 F-FDA), 6-[ 18 F]-fluoro- l -3,4-dihydroxyphenylalanine ( 18 F-DOPA), and 2-[ 18 F]-fluoro-2-deoxy- d -glucose. We review the currently available data on the performance of anatomical imaging, SPECT, and PET for the detection of (metastatic) PPGL as well as parasympathetic head and neck paragangliomas. We show that there appears to be no ‘gold-standard’ imaging technique for all patients with (suspected) PPGL. A tailor-made approach is warranted, guided by clinical, biochemical, and genetic characteristics. In the current era of a growing number of PET tracers, PPGL imaging has moved beyond tumor localization towards functional characterization of tumors.