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The Utility of Metaiodobenzylguanidine Single Photon Emission Computed Tomography/Computed Tomography (MIBG SPECT/CT) for the Diagnosis of Pheochromocytoma

  • Endocrine Tumors
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Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The enhancement of metaiodobenzylguanidine single photon emission computed tomography (MIBG SPECT) imaging through the addition of CT images fused with SPECT data (coregistered MIBG SPECT/CT imaging) is new technology that allows direct correlation of anatomical and functional information. We hypothesized that MIBG SPECT/CT imaging would provide additional information and improve diagnostic confidence for the radiological localization of a pheochromocytoma, in particular for patients at high risk of multifocal or recurrent disease.

Methods

A retrospective study of all patients investigated by MIBG SPECT/CT at our institution from 2006 to 2008 for a suspected pheochromocytoma was performed. Each case was compared with conventional radiological investigations to determine whether MIBG SPECT/CT was able to improve diagnostic confidence and provide additional diagnostic information compared with conventional imaging alone.

Results

Twenty-two patients had MIBG SPECT/CT imaging for a suspected pheochromocytoma. Fourteen patients had positive MIBG SPECT/CT imaging results correlating with imaging by CT or magnetic resonance imaging in all cases. In six cases, MIBG SPECT/CT provided additional information that altered the original radiological diagnosis. Five patients with a pheochromocytoma-associated germline mutation had multifocal disease excluded by MIBG SPECT/CT. Patients without a germline mutation that had positive biochemistry and a solitary lesion with conventional imaging had no diagnostic improvement with MIBG SPECT/CT imaging.

Conclusions

MIBG SPECT/CT fusion imaging is a sensitive and specific radiological imaging tool for patients suspected to have pheochromocytoma. The particular strengths of MIBG SPECT/CT are detection of local recurrence, small extra-adrenal pheochromocytomas, multifocal tumors, or the presence of metastatic disease.

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Acknowledgement

GMR is a recipient of the National Health and Medical Research Council (NHMRC, Australia) Postgraduate Research Scholarship, the Cancer Institute of New South Wales (CINSW, Australia) Postgraduate Scholarship, and the Royal Australasian College of Surgeons (RACS) Surgeon Scientist Scholarship.

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Oral presentation to the Conjoint Annual Scientific Congress, Hong Kong, May 2008.

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Authors and Affiliations

  1. Cancer Genetics, Kolling Institute of Medical Research, Royal North Shore Hospital, University of Sydney, Sydney, Australia

    Goswin Y. Meyer-Rochow FRACS, Diana E. Benn PhD, Bruce G. Robinson MD & Stan B. Sidhu PhD

  2. Nuclear Medicine Department, Royal North Shore Hospital, University of Sydney, Sydney, Australia

    Geoff P. Schembri FRACP & Paul J. Roach FRACP

  3. Endocrine Surgical Department, Royal North Shore Hospital, University of Sydney, Reserve Road, St Leonards, NSW, 2065, Australia

    Goswin Y. Meyer-Rochow FRACS, Mark S. Sywak FRACS, Leigh W. Delbridge MD & Stan B. Sidhu PhD

  4. Department of Endocrinology, Royal North Shore Hospital, University of Sydney, Sydney, Australia

    Bruce G. Robinson MD

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  1. Goswin Y. Meyer-Rochow FRACS
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Correspondence to Goswin Y. Meyer-Rochow FRACS.

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Meyer-Rochow, G.Y., Schembri, G.P., Benn, D.E. et al. The Utility of Metaiodobenzylguanidine Single Photon Emission Computed Tomography/Computed Tomography (MIBG SPECT/CT) for the Diagnosis of Pheochromocytoma. Ann Surg Oncol 17, 392–400 (2010). https://doi.org/10.1245/s10434-009-0850-5

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  • DOI: https://doi.org/10.1245/s10434-009-0850-5

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