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Clinical Scorecard: A Functional Imaging Strategy Utilizing FDG for Phaeochromocytoma and Paraganglioma Assessment

At a Glance

Key Highlights

• FDG demonstrated the highest detection rate (94.7%) among imaging modalities.

• 100% detection in patients with SDHB and VHL mutations using FDG.

• Metastatic disease detection rates were 100% for FDG, 92.3% for Dotatate, and 84.6% for mIBG.

• Correlation found between FDG SUVmax and plasma 3-methoxytyramine levels.

• Triple functional imaging approach utilized for comprehensive assessment.

Guideline-Based Recommendations

Diagnosis

• Utilize a combination of anatomical and functional imaging for PPGL diagnosis.

Management

• Surgery is the mainstay of treatment; consider molecular radiotherapy for metastatic or inoperable cases.

Monitoring & Follow-up

• Regular imaging and biochemical assessment for patients with germline mutations.

Risks

• Higher risk of malignancy in paragangliomas compared to phaeochromocytomas.

Patient & Prescribing Data

Patients with confirmed localised and metastatic PPGL.

Molecular radiotherapy options include 131I-mIBG and 177Lu-DOTATATE for specific cases.

Clinical Best Practices

• Implement FDG-first functional imaging strategy for diagnosis and staging.

• Consider genetic testing for patients with PPGL to identify familial syndromes.

Related Resources & Content

• Phaeochromocytoma and Paraganglioma: A Review of the Literature - National Institutes of Health

• Guidelines for the Management of Phaeochromocytoma and Paraganglioma - European Society of Cardiology

• Patient Guide to Phaeochromocytoma - American Thyroid Association

• NCCN Guidelines for Phaeochromocytoma and Paraganglioma - National Comprehensive Cancer Network

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