title: Intraindividual comparison of 123I-mIBG SPECT/MRI, 123I-mIBG SPECT/CT, and MRI for the detection of adrenal pheochromocytoma in patients with elevated urine or plasma catecholamines.
abstract: OBJECTIVE
  To determine the diagnostic performance of ¹²³I-metaiodobenzylguanidine (mIBG) SPECT/MRI fusion, ¹²³I-mIBG SPECT/CT and adrenal MRI for the detection of pheochromocytoma in patients with elevated urine or plasma catecholamines.
  
  
  METHODS
  Twenty-two consecutive patients underwent both a whole-body ¹²³I-mIBG scan with SPECT/CT of the adrenal region and MRI of the adrenal glands. Fused SPECT/MRI, SPECT/CT, and MRI scans were evaluated. Imaging results were analyzed both on a per-patient and on a per-lesion basis. Histopathology and/or clinical and radiological follow-up served as the reference standard.
  
  
  RESULTS
  Sixteen adrenal tumors were found in thirteen patients. On a per-lesion basis, SPECT/CT had a sensitivity of 87.5%, a specificity of 93.8%, and an overall accuracy of 92.5%. MRI had a sensitivity of 87.5%, a specificity of 96.9%, and an overall accuracy of 95.0%. On a per-patient basis, both SPECT/CT and MRI had a sensitivity of 85.7%, a specificity of 93.3%, and an overall accuracy of 90.9%. SPECT/CT was concordant with MRI in 81.8% of cases. SPECT/MRI fusion was superior to both SPECT/CT and MRI and had a sensitivity of 100% on both a per-lesion and a per-patient basis.
  
  
  CONCLUSIONS
  ¹²³I-mIBG SPECT/MRI has the highest sensitivity and accuracy for the detection and localization of pheochromocytomas. SPECT/CT and MRI of the adrenal glands are equivalent diagnostic procedures. However, MRI offers the advantage of fully diagnostic assessment of adrenal lesions other than pheochromocytoma undetectable by ¹²³I-mIBG.
authors.affiliation: Department of Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. t.derlin@uke.uni-hamburg.de
authors.forename: Thorsten
authors.initials: T
authors.lastname: Derlin
authors.forename: Jasmin D
authors.initials: JD
authors.lastname: Busch
authors.forename: Christian
authors.initials: C
authors.lastname: Wisotzki
authors.forename: Bjoern P
authors.initials: BP
authors.lastname: Schoennagel
authors.forename: Peter
authors.initials: P
authors.lastname: Bannas
authors.forename: László
authors.initials: L
authors.lastname: Papp
authors.forename: Susanne
authors.initials: S
authors.lastname: Klutmann
authors.forename: Christian R
authors.initials: CR
authors.lastname: Habermann
mesh_terms: D019797:3-Iodobenzylguanidine; D000310:Adrenal Gland Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000652:urine; D000328:Adult; D000368:Aged; D002395:Catecholamines / Q000097:blood* / Q000652:urine*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000097:blood / Q000000981:diagnostic imaging* / Q000652:urine; D015203:Reproducibility of Results; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D002395:Catecholamines; D007457:Iodine Radioisotopes; D019797:3-Iodobenzylguanidine