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Nuclear Medicine |
1 From the Departments of Internal Medicine, Division of Nuclear Medicine (B.L.S., B.S., J.C.S.), Surgery (N.W.T.), and Radiology (I.R.F.), University of Michigan Medical Center, 1500 E Medical Center Dr, Ann Arbor, MI 48109. Received July 9, 1998; revision requested August 18; revision received September 16; accepted December 16. Supported in part by grant CA54216 from the National Cancer Institute and grant MO1 RR 00042 from the University of Michigan Clinical Research Center. Address reprint requests to B.L.S. (e-mail: bshulkin@umich.edu).
PURPOSE: To assess the sensitivity of positron emission tomography (PET) with 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) in pheochromocytomas and, secondarily, to compare images obtained with FDG PET to those obtained with metaiodobenzylguanidine (MIBG) scintigraphy.
MATERIALS AND METHODS: Twenty-nine patients with one or more known or subsequently proved pheochromocytomas underwent FDG PET (35 scans) and MIBG scintigraphy (35 scans). Tumor uptake of FDG was quantified on positive PET scans.
RESULTS: Tumor uptake of FDG was detected in 22 of 29 patients. Most benign (seven of 12 patients) and most malignant (15 of 17 patients) pheochromocytomas and their metastases avidly concentrated FDG. In four patients whose pheochromocytomas failed to accumulate MIBG, uptake of FDG in the tumors was intense. For the majority of the 16 patients whose tumors concentrated both agents, however, ratings for MIBG images compared to FDG PET images for delineation of the tumor in comparison to background and normal organ accumulation were superior for nine patients (56%) and as good or better for 14 (88%).
CONCLUSION: Most pheochromocytomas accumulate FDG. Uptake is found in a greater percentage of malignant than benign pheochromocytomas. FDG PET is especially useful in defining the distribution of those pheochromocytomas that fail to concentrate MIBG.
Index terms: Adrenal gland, emission CT (ECT), 86.12161, 86.12162, 86.12163 • Fluorine, radioactive metaiodobenzylguanidine (MIBG) • Pheochromocytoma, 67.3163, 86.328
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