A Functional Imaging Strategy Utilizing FDG for Phaeochromocytoma and Paraganglioma Assessment
By
Norah Alhazzaa
Mohammad M. R. Eddama
Fawziah Alorfi
Teng Teng Chung
Helen Simpson
Srirangalingam Umasuthan
Steve Hurel
Virginia Rozalen-Garcia
Tom Kurzawinski
Simon Wan
Jamshed Bomanji
Mark Gaze
Tarek Ezzat Abdel-Aziz
July 21, 2026
Clinical Scorecard: A Functional Imaging Strategy Utilizing FDG for Phaeochromocytoma and Paraganglioma Assessment
At a Glance
Category Detail
Condition Phaeochromocytomas and Paragangliomas (PPGLs) Key Mechanisms Functional imaging modalities including 18F-FDG PET CT/MRI, 68Ga-DOTATATE PET/CT, and 123I-mIBG SPECT/CT for detection and assessment. Target Population Patients diagnosed with PPGL, including those with primary and metastatic disease. Care Setting Tertiary referral centre
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
