Sensitivity and positive predictive value of CT, MRI and 123I-MIBG scintigraphy in localizing pheochromocytomas: A prospective study

Lumachi, Franco; Tregnaghi, Alberto; Zucchetta, Pietro; Marzola, Maria Cristina; Cecchin, Diego; Grassetto, Gaia; Bui, Franco

doi:10.1097/00006231-200607000-00006

Cited by 102 publications

(65 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although MIBG scanning is reported to have a sensitivity of 83-100% in the detection of benign pheochromocytomas in case finding studies, this sensitivity is considerably reduced in familial, extraadrenal or malignant paragangliomas (Nielsen et al 1996, van der Harst et al 2001, Ilias et al 2003, Lumachi et al 2006. In our study, use of 123 I-MIBG for detection of intra-and extra-adrenal paragangliomas combined revealed a sensitivity of only 74% in our cohort with mostly familial paragangliomas.…”

Section: B Havekes Et Al: Screening In Sdhd Patientscontrasting

confidence: 58%

Pheochromocytomas and extra-adrenal paragangliomas detected by screening in patients with SDHD-associated head-and-neck paragangliomas

Havekes

Klaauw²,

Weiss³

et al. 2009

Endocrine-Related Cancer

View full text Add to dashboard Cite

Patients with SDHD-associated head-and-neck paragangliomas (HNP) are at risk for developing pheochromocytomas for which screening has been advised. To assess clinical, biochemical, and radiological outcomes of screening in a large single-center cohort of SDHD-positive patients with HNP and to address the necessity for repetitive follow-up, we evaluated 93 patients with SDHDassociated HNP (p.Asp92Tyr, p.Leu139Pro). Screening consisted of measurement of 24 h urinary excretion of catecholamines and/or their metabolites in duplicate, which was repeated with intervals of 2 years if initial biochemical screening was negative. In patients, in whom urinary excretion was above the reference limit, imaging studies with 123 I-MIBG (metaiodobenzylguanidine) scintigraphy and magnetic resonance imaging (MRI) and/or computed tomography (CT) were performed. Pheochromocytomas and extra-adrenal paragangliomas were treated surgically after appropriate blockade. Median follow-up was 4.5 years (range 0.5-19.5 years). Twenty-eight out of the 93 patients were included in our study and underwent additional imaging for pheochromocytomas/extra-adrenal paragangliomas. In 11 out of the 28 patients intra-adrenal pheochromocytomas were found. Extra-adrenal paragangliomas were discovered in eight patients. These tumors were detected during initial screening in 63% of cases, whereas 37% were detected after repeated biochemical screening. One patient was diagnosed with a biochemically silent pheochromocytoma. The high prevalence of pheochromocytomas/extra-adrenal paragangliomas in patients with SDHD-associated HNP warrants regular screening for tumors in these patients. Paragangliomas that do not secrete catecholamines might be more prevalent than previously reported. Future studies will have to establish whether routine imaging studies should be included in the screening of SDHD mutation carriers, irrespective of biochemical screening.

show abstract

Section: B Havekes Et Al: Screening In Sdhd Patientscontrasting

confidence: 58%

Pheochromocytomas and extra-adrenal paragangliomas detected by screening in patients with SDHD-associated head-and-neck paragangliomas

Havekes

Klaauw²,

Weiss³

et al. 2009

Endocrine-Related Cancer

View full text Add to dashboard Cite

show abstract

“…Ninety-five percent of extra-adrenal pheochromocytomas are found in the abdomen and pelvis [79]. Both CT and MRI have a sensitivity of 98%-100% for adrenal pheochromocytomas [80], but MRI is more sensitive (94% versus 90%) for extra-adrenal pheochromocytomas [17,81,82]. Unfortunately, these tests have a specificity of approximately 70% because of the high incidence of adrenal incidentalomas [83].…”

Section: Imagingmentioning

confidence: 99%

“…The absence of ␤-emission and a shorter half-life result in a 20 times greater initial level of radioactivity administered to the patient without increasing the absorbed radiation dose, which accounts for the greater sensitivity of 123 I-MIBG [88]. In centers where this is not available, however, sitive agents include 18 F-fluorodeoxyglucose [90] and 82 rubidium [91], while more specific agents incorporate 11 C-hydroxyephedrine [92] and 6-18 F-fluorodopamine [87]. While studies have shown remarkably high sensitivity and specificity, the series are small and many of the agents are not yet in widespread clinical use.…”

Section: Imagingmentioning

confidence: 99%

Pheochromocytoma: Current Approaches and Future Directions

et al. 2008

View full text Add to dashboard Cite

After completing this course, the reader should be able to:1. Use current practice methods in the diagnosis of pheochromocytomas.2. Employ current practice methods in the treatment of pheochromocytomas.3. Evaluate the current molecular research that contributes to the treatment of pheochromocytomas.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTPheochromocytomas are rare catecholamine-secreting tumors that arise from chromaffin tissue within the adrenal medulla and extra-adrenal sites. Because of the excess secretion of hormones, these tumors often cause debilitating symptoms and a poor quality of life. While medical management plays a significant role in the treatment of pheochromocytoma patients, surgical excision remains the only cure. Improved medical management and surgical techniques and an increased understanding of hereditary disease have improved the outcome of pheochromocytoma patients with benign disease; however, the outcome of patients with malignant disease remains poor. In this review, we discuss the presentation, diagnosis, management, and future directions in the management of this disease. The Oncologist

show abstract

“…Other studies had suggested the use of plasma-free metanephrines (99% sensitivity) or urinary-fractionated metanephrines (97% sensitivity) as the test of first choice for diagnosing pheochromocytoma [1,11]. CT scanning and MRI have similar sensitivities (> 90%) and specificities (79-80%) [1,17,18]. However, CT scan is still the method most commonly used to evaluate patients suspected of having adrenal pathology [19,20], and it is the preferred initial imaging modality in diagnosing pheochromocytoma in our centre.…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Pheochromocytoma in a Contemporary Setting

Woon

2013

J Curr Surg

View full text Add to dashboard Cite

Background: Pheochromocytomas are rare, with a reported incidence of 2 -8 cases per million persons, per year. The clinical presentation of pheochromocytomas is highly variable, making diagnosis challenging. Occasionally, the potent effects of the catecholamines can also cause "pheochromocytoma crisis" which can be fatal with around 800 deaths in the United States annually. The aim of this project is to study the clinical presentation, sensitivity of biochemical tests and imaging studies, preoperative work-up, pathological findings and surgical results of patients with pheochromocytoma.

show abstract

Sensitivity and positive predictive value of CT, MRI and 123I-MIBG scintigraphy in localizing pheochromocytomas: A prospective study

Abstract: Our data suggest that this imaging protocol should be used in all patients with biochemically confirmed pheochromocytoma.

Cited by 102 publications

References 21 publications

Pheochromocytomas and extra-adrenal paragangliomas detected by screening in patients with SDHD-associated head-and-neck paragangliomas

Pheochromocytomas and extra-adrenal paragangliomas detected by screening in patients with SDHD-associated head-and-neck paragangliomas

Pheochromocytoma: Current Approaches and Future Directions

Surgical Management of Pheochromocytoma in a Contemporary Setting

Contact Info

Product

Resources

About