title: Usefulness of 123I-MIBG scintigraphy in the evaluation of patients with known or suspected primary or metastatic pheochromocytoma or paraganglioma: results from a prospective multicenter trial.
abstract: Although (123)I-MIBG has been in clinical use for the imaging of pheochromocytoma for many years, a large multicenter evaluation of this agent has never been performed. The present study was designed to provide a prospective confirmation of the performance of (123)I-MIBG scintigraphy for the evaluation of patients with known or suspected primary or metastatic pheochromocytoma or paraganglioma.
  
  
  METHODS
  A total of 81 patients with a prior history of primary or metastatic pheochromocytoma or paraganglioma and 69 with suspected pheochromocytoma or paraganglioma based on symptoms of catecholamine excess, CT or MRI findings, or elevated catecholamine or metanephrine levels underwent whole-body planar and selected SPECT 24 h after the administration of (123)I-MIBG. Images were independently interpreted by 3 masked readers, with consensus requiring agreement of at least 2 readers. Final diagnoses were based on histopathology, correlative imaging, catecholamine or metanephrine measurements, and clinical follow-up.
  
  
  RESULTS
  Among 140 patients with definitive diagnoses (91, disease present; 49, disease absent), (123)I-MIBG planar scintigraphy had a sensitivity and specificity of 82%. For patients evaluated for suspected disease, sensitivity and specificity were 88% and 84%, respectively. For the subpopulations of adrenal (pheochromocytoma) and extraadrenal (paraganglioma) tumors, sensitivities were 88% and 67%, respectively. The addition of SPECT increased reader confidence but minimally affected sensitivity and specificity.
  
  
  CONCLUSIONS
  This prospective study demonstrated a sensitivity of 82%-88% and specificity of 82%-84% for (123)I-MIBG imaging used in the diagnostic assessment of primary or metastatic pheochromocytoma or paraganglioma.
authors.affiliation: Department of Nuclear Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Wiseman
authors.forename: Karel
authors.initials: K
authors.lastname: Pacak
authors.forename: Mary S
authors.initials: MS
authors.lastname: O'Dorisio
authors.forename: Donald R
authors.initials: DR
authors.lastname: Neumann
authors.forename: Alan D
authors.initials: AD
authors.lastname: Waxman
authors.forename: David A
authors.initials: DA
authors.lastname: Mankoff
authors.forename: Sherif I
authors.initials: SI
authors.lastname: Heiba
authors.forename: Aldo N
authors.initials: AN
authors.lastname: Serafini
authors.forename: Sabah S
authors.initials: SS
authors.lastname: Tumeh
authors.forename: Natalie
authors.initials: N
authors.lastname: Khutoryansky
authors.forename: Arnold F
authors.initials: AF
authors.lastname: Jacobson
mesh_terms: D019797:3-Iodobenzylguanidine; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010235:Paraganglioma / Q000000981:diagnostic imaging* / Q000556:secondary*; D010673:Pheochromocytoma / Q000000981:diagnostic imaging* / Q000556:secondary*; D011446:Prospective Studies; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine
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