Abstract
This Practice Point commentary discusses the findings and limitations of a retrospective study by Bhatia et al. that compared the performance of 123I-labeled metaiodobenzylguanide (123I-MIBG) scintigraphy with that of cross-sectional CT and MRI for the detection of pheochromocytomas. The sensitivity of 123I-MIBG scintigraphy for detection of adrenal pheochromocytomas was higher than that for extra-adrenal pheochromocytomas (85% versus 58%). Adrenal pheochromocytomas ≥5 cm in diameter were more likely to be detected by 123I-MIBG scintigraphy than those <5 cm (92% versus 79%, respectively). The rate of detection by 123IMIBG scintigraphy for extra-adrenal pheochromocytomas was not influenced by tumor size. I discuss how the characteristics of affected patients (e.g. hereditary syndromes, history of previous pheochromocytoma, and the presence of multifocal, bilateral, extra-adrenal disease, etc.) influence imaging decisions and interpretation. The findings of Bhatia et al. suggest that abdominal MRI or CT should be the initial imaging modality in a patient with a (biochemically) suspected pheochromocytoma.
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Koch, C. Should 123I-MIBG scintigraphy be part of the workup for pheochromocytomas?. Nat Rev Endocrinol 5, 76–77 (2009). https://doi.org/10.1038/ncpendmet1047
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DOI: https://doi.org/10.1038/ncpendmet1047