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).
OBJECTIVE
Imaging modalities available for the localization of phaeochromocytoma (PHEO) include computed tomography (CT), magnetic resonance imaging (MRI), [(123)I]- or [(131)I]-labelled metaiodobenzylguanidine ((123/131)I-MIBG) scintigraphy and 6-[(18)F]-fluorodopamine ((18)F-FDA) positron emission tomography (PET). Our aim was to investigate the yield of (18)F-FDA PET vs. biochemical testing and other imaging techniques to establish the diagnosis and location of PHEO.


METHODS
The study included 99 consecutive patients (35 Males, 64 Females, mean +/- SD age 46.4 +/- 13.4 years), who underwent (18)F-FDA PET, biochemical testing (plasma catecholamines and free metanephrines) and CT and/or MRI. The majority (78%) also underwent (123/131)I-MIBG.


RESULTS
In total 26 patients had non-metastatic PHEO, 34 patients had metastatic PHEO, and PHEO was ruled out in 39 patients. Investigations to rule out or confirm PHEO yielded the following sensitivity/specificity: plasma metanephrines 97/95%, (18)F-FDA 92/90%, (123)I-MIBG 83/100%, (123/131)I-MIBG 70/100%, CT 100/41%, MRI 98/60%. Sensitivities for localizing non-metastatic PHEO on a per-lesion base were: CT 97%, MRI 92%, (18)F-FDA 78%, (123)I-MIBG 78% and (123/131)I-MIBG 76%. Sensitivities for detecting metastases on a per-patient base were: CT and MRI 100%, (18)F-FDA 97%, (123)I-MIBG 85% and (123/131)I-MIBG 65%.


CONCLUSIONS
For tumour localization, (18)F-FDA PET and (123/131)I-MIBG scintigraphy perform equally well in patients with non-metastatic PHEO, but metastases are better detected by (18)F-FDA PET than by (123/131)I-MIBG.
Timmers
Henri J L M
HJ
Reproductive and Adult Endocrinology Program, National Institutes of Health, Bethesda, MD 20892-1109, USA.
Eisenhofer
Graeme
G
Carrasquillo
Jorge A
JA
Chen
Clara C
CC
Whatley
Millie
M
Ling
Alexander
A
Adams
Karen T
KT
Pacak
Karel
K
D000328:Adult; D004298:Dopamine / Q000031:analogs & derivatives* / Q000737:chemistry; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging / Q000379:methods*; D010673:Pheochromocytoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D049268:Positron-Emission Tomography / Q000379:methods*
C029253:6-fluorodopamine; D004298:Dopamine