18F-FDG Avidity of Pheochromocytomas and Paragangliomas: A New Molecular Imaging Signature?

• DOI: 10.2967/jnumed.108.060731
• Publication Date: 2009-04-17T02:25:05Z
• Authors: David Taïeb; Frederic Sebag; Anne Barlier; Laurent Tessonnier; Fausto F. Palazzo; Isabelle Morange; Patricia Niccoli-...; Nicolas Fakhry; Catherine De Micco; Serge Cammilleri; Alain Enjalbert; Jean-François Henry; Olivier Mundler
• Keywords: Standardized uptake value; Avidity; Von Hippel–Lindau disease

Our objective was to evaluate (18)F-FDG PET uptake in patients with nonmetastatic and metastatic chromaffin-derived tumors.Twenty-eight consecutive unrelated chromaffin tumors, including 9 genetically determined disease, were studied. A combination of preoperative imaging work-up, surgical findings, pathologic analyses used classify the into 2 groups: those disease (presumed benign, n = 18) tumors (n 10). performed all cases. Visual quantitative individually graded for each tumor. Somatic mutations succinate dehydrogenase subunits B D Von-Hippel Lindau genes also evaluated 6 benign sporadic tumor samples.All but showed significantly increased on visual analysis. The maximum standardized value (SUVmax) ranged from 1.9 42 (mean +/- SD, 8.2 9.7; median, 4.6) 2.3 29.3 9.7 8.4; 7.4) tumors. No statistical difference observed between groups (P 0.44), dehydrogenase-related notable being most (18)F-FDG-avid (SUVmax, 42, 29.3, 21, 17, 5.3). Succinate Lindau-related had a higher SUVmax than did neurofibromatosis type 1 multiple endocrine neoplasia 2A syndrome-related 0.02). superior (131)I-metaiodobenzylguanidine one. By contrast, underestimated extent compared 6-(18)F-fluorodopa PET, 5 pheochromocytoma. However, (germline somatic) functional dedifferentiation do not adequately explain since highly avid (18)F-FDG.(18)F-FDG positivity is almost constant feature pheochromocytomas paragangliomas. It may be considered molecular signature such although which aspect plethora changes associated dedifferentiation, germline genetic defects, or adaptive response hypoxia responsible this characteristic requires further elucidation.