[Pheochromocytoma and paraganglioma : Importance of diagnostic imaging]. / Phäochromozytom und Paragangliom : Stellenwert der bildgebenden Diagnostik.
Radiologe
; 59(11): 975-981, 2019 Nov.
Article
in De
| MEDLINE
| ID: mdl-31338528
ABSTRACT
CLINICAL BACKGROUND:
If pheochromocytoma (PC) or paraganglioma (PGL) is diagnosed based on serologic studies, imaging is required to locate the adrenal mass for further management. Besides pathognomonic hormonal findings, PC/PGL can exhibit typical imaging features. However, PC/PGL can also show morphological overlap with other pathologies. STANDARD RADIOLOGICALMETHODS:
The modality of choice for evaluation of PC is CT. In case of extra-adrenal location, MRI is superior to CT. Imaging with PET-CT provides complementary information in the differentiation of PC/PGL and is recommended as the imaging modality of choice for malignant PC/PGL. 68Ga-DOTATATE (or 68Ga-DOTATOC/ 68Ga-DOTANOC) PET-CT has high sensitivity for SDHx-mutated PC/PGL and serves for planning of radioreceptor therapy with somatostatin analogues. In contrast, 123I-metaiodobenzylguanidine (MIBG) scintigraphy is important in assessing the potential efficacy of radioreceptor therapy with MIBG. METHODICAL DETAILS The CT protocol for PC evaluation should include non-enhanced, arterial, portal-venous and late phases; the latter for the evaluation of wash-out. Recent studies indicate non-enhanced CT alone may be sufficient to rule out PC. For MRI, in- and opposed-phase sequences should be additionally acquired. PRACTICALRECOMMENDATIONS:
A relevant proportion of PC is diagnosed incidentally. Therefore, imaging of PC will gain further importance. Recent studies show better response rates of PC/PGL after radioreceptor therapy with somatostatin analogues (177Lu-DOTATATE) than with MIBG. Therefore, 68Ga-DOTATATE PET-CT gains further importance-for diagnostic imaging and therapy planning.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Paraganglioma
/
Pheochromocytoma
/
Adrenal Gland Neoplasms
/
Positron-Emission Tomography
/
Positron Emission Tomography Computed Tomography
Type of study:
Diagnostic_studies
/
Guideline
Limits:
Humans
Language:
De
Year:
2019
Type:
Article