Original Article

European Journal of Nuclear Medicine and Molecular Imaging

, Volume 37, Issue 3, pp 484-493

First online:

Clinical value of 18F-fluorodihydroxyphenylalanine positron emission tomography/computed tomography (18F-DOPA PET/CT) for detecting pheochromocytoma

  • Markus LusterAffiliated withDepartment of Nuclear Medicine, University of Ulm Email author 
  • , Wolfram KargesAffiliated withDivision of Endocrinology and Diabetes, RWTH Aachen
  • , Katrin ZeichAffiliated withDepartment of Nuclear Medicine, University of Ulm
  • , Sandra PaulsAffiliated withDepartment of Radiology, University of Ulm
  • , Frederik A. VerburgAffiliated withDepartment of Nuclear Medicine, University of Würzburg
  • , Henning DralleAffiliated withDepartment of General, Visceral and Vascular Surgery, University Halle-Wittenberg
  • , Gerhard GlattingAffiliated withDepartment of Nuclear Medicine, University of Ulm
  • , Andreas K. BuckAffiliated withDepartment of Nuclear Medicine, University of Ulm
  • , Christoph SolbachAffiliated withDepartment of Nuclear Medicine, University of Ulm
    • , Bernd NeumaierAffiliated withDepartment of Nuclear Medicine, University of UlmSection for Radiochemistry, Max-Planck-Institut für neurologische Forschung
    • , Sven N. ReskeAffiliated withDepartment of Nuclear Medicine, University of Ulm
    • , Felix M. MottaghyAffiliated withDepartment of Nuclear Medicine, University of UlmDepartment of Nuclear Medicine, RWTH Aachen

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In detecting pheochromocytoma (PHEO), positron emission tomography (PET) with the radiolabelled amine precursor 18F-fluorodihydroxyphenylalanine (18F-DOPA) offers excellent specificity, while computed tomography (CT) provides high sensitivity and ability to localize lesions; therefore, the combination of these modalities could be advantageous in this setting. The aim of this study was to investigate whether combined 18F-DOPA PET/CT more accurately detects and localizes PHEO lesions than does each modality alone.


18F-DOPA PET, CT and 18F-DOPA PET/CT images of 25 consecutive patients undergoing diagnostic scanning of suspected sporadic or multiple endocrine neoplasia type 2 syndrome-associated PHEO were reviewed retrospectively in randomized sequence. Two blinded observers scored the images regarding the likelihood of PHEO being present and localizable. Results were correlated with subsequent clinical history and, when available, histology.


Of the 19 lesions detected by all three modalities, PET identified each as positive for PHEO, but was unable to definitively localize 15 of 19 (79%). CT could definitively localize all 19 lesions, but could not definitively diagnose or exclude PHEO in 18 of 19 (95%) lesions. Furthermore, CT falsely identified as negative for PHEO one lesion which was judged to be positive for this tumor by both PET and PET/CT. Only in PET/CT scans were all 19 lesions accurately characterized and localized. On a per-patient basis, the sensitivity of 18F-DOPA PET/CT for PHEO was 100% and the specificity 88%, with a 100% positive predictive value and an 88% negative predictive value.


18F-DOPA PET/CT more accurately diagnoses and localizes adrenal and extra-adrenal masses suspicious for PHEO than do 18F-DOPA PET or CT alone.


Pheochromocytoma Multiple endocrine neoplasia type 2 (MEN2) 18F-fluorodihydroxyphenylalanine (18F-DOPA) Positron emission tomography (PET) Computed tomography (CT) Staging