Usefulness of123I-MIBG scintigraphy in the evaluation of patients with known or suspected primary or metastatic pheochromocytoma or paraganglioma

Results from a prospective multicenter trial

Gregory A. Wiseman, Karel Pacak, Mary S. O'Dorisio, Donald R. Neumann, Alan D. Waxman, David A. Mankoff, Sherif I. Heiba, Aldo N Serafini, Sabah S. Tumeh, Natalie Khutoryansky, Arnold F. Jacobson

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

Although 123I-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 123I-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 123I-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), 123I-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. Conclusion: This prospective study demonstrated a sensitivity of 82%288% and specificity of 82%-84% for 123I-MIBG imaging used in the diagnostic assessment of primary or metastatic pheochromocytoma or paraganglioma.

Original languageEnglish
Pages (from-to)1448-1454
Number of pages7
JournalJournal of Nuclear Medicine
Volume50
Issue number9
DOIs
StatePublished - Sep 1 2009

Fingerprint

3-Iodobenzylguanidine
Paraganglioma
Pheochromocytoma
Radionuclide Imaging
Multicenter Studies
Metanephrine
Catecholamines
Single-Photon Emission-Computed Tomography
Sensitivity and Specificity
Prospective Studies
Neoplasms

Keywords

  • I-MIBG
  • Neuroendocrine tumors
  • Paraganglioma
  • Pheochromocytoma
  • Scintigraphy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Usefulness of123I-MIBG scintigraphy in the evaluation of patients with known or suspected primary or metastatic pheochromocytoma or paraganglioma : Results from a prospective multicenter trial. / Wiseman, Gregory A.; Pacak, Karel; O'Dorisio, Mary S.; Neumann, Donald R.; Waxman, Alan D.; Mankoff, David A.; Heiba, Sherif I.; Serafini, Aldo N; Tumeh, Sabah S.; Khutoryansky, Natalie; Jacobson, Arnold F.

In: Journal of Nuclear Medicine, Vol. 50, No. 9, 01.09.2009, p. 1448-1454.

Research output: Contribution to journalArticle

Wiseman, Gregory A. ; Pacak, Karel ; O'Dorisio, Mary S. ; Neumann, Donald R. ; Waxman, Alan D. ; Mankoff, David A. ; Heiba, Sherif I. ; Serafini, Aldo N ; Tumeh, Sabah S. ; Khutoryansky, Natalie ; Jacobson, Arnold F. / Usefulness of123I-MIBG scintigraphy in the evaluation of patients with known or suspected primary or metastatic pheochromocytoma or paraganglioma : Results from a prospective multicenter trial. In: Journal of Nuclear Medicine. 2009 ; Vol. 50, No. 9. pp. 1448-1454.
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abstract = "Although 123I-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 123I-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 123I-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), 123I-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. Conclusion: This prospective study demonstrated a sensitivity of 82{\%}288{\%} and specificity of 82{\%}-84{\%} for 123I-MIBG imaging used in the diagnostic assessment of primary or metastatic pheochromocytoma or paraganglioma.",
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