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. 2019 Sep;46(10):2112-2137.
doi: 10.1007/s00259-019-04398-1. Epub 2019 Jun 29.

European Association of Nuclear Medicine Practice Guideline/Society of Nuclear Medicine and Molecular Imaging Procedure Standard 2019 for radionuclide imaging of phaeochromocytoma and paraganglioma

David Taïeb  1 , Rodney J Hicks  2 , Elif Hindié  3 , Benjamin A Guillet  4 , Anca Avram  5 , Pietro Ghedini  6 , Henri J Timmers  7 , Aaron T Scott  8 , Saeed Elojeimy  9 , Domenico Rubello  10 , Irène J Virgolini  11 , Stefano Fanti  6 , Sona Balogova  12   13 , Neeta Pandit-Taskar  14 , Karel Pacak  15
Affiliations

European Association of Nuclear Medicine Practice Guideline/Society of Nuclear Medicine and Molecular Imaging Procedure Standard 2019 for radionuclide imaging of phaeochromocytoma and paraganglioma

David Taïeb et al. Eur J Nucl Med Mol Imaging. 2019 Sep.

Abstract

Purpose: Diverse radionuclide imaging techniques are available for the diagnosis, staging, and follow-up of phaeochromocytoma and paraganglioma (PPGL). Beyond their ability to detect and localise the disease, these imaging approaches variably characterise these tumours at the cellular and molecular levels and can guide therapy. Here we present updated guidelines jointly approved by the EANM and SNMMI for assisting nuclear medicine practitioners in not only the selection and performance of currently available single-photon emission computed tomography and positron emission tomography procedures, but also the interpretation and reporting of the results.

Methods: Guidelines from related fields and relevant literature have been considered in consultation with leading experts involved in the management of PPGL. The provided information should be applied according to local laws and regulations as well as the availability of various radiopharmaceuticals.

Conclusion: Since the European Association of Nuclear Medicine 2012 guidelines, the excellent results obtained with gallium-68 (68Ga)-labelled somatostatin analogues (SSAs) in recent years have simplified the imaging approach for PPGL patients that can also be used for selecting patients for peptide receptor radionuclide therapy as a potential alternative or complement to the traditional theranostic approach with iodine-123 (123I)/iodine-131 (131I)-labelled meta-iodobenzylguanidine. Genomic characterisation of subgroups with differing risk of lesion development and subsequent metastatic spread is refining the use of molecular imaging in the personalised approach to hereditary PPGL patients for detection, staging, and follow-up surveillance.

Keywords: Guidelines; Paraganglioma; Phaeochromocytoma; Positron emission tomography; Radionuclide imaging; Somatostatin analogues; Targeted radionuclide therapy.

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Conflict of interest statement

Conflict of interest RH has received research funding from Ipsen, Novartis, and Clarity Pharmaceuticals and holds stock in Telix Pharmaceuticals on behalf of his institution.

NPT has received consultant/advisory board/honoraria (current/past) from Y-mAbs, Progenics, Bayer, and MedImmune/AstraZeneca and sponsored trials/research support from ImaginAb, Genentech, and Actinium Pharma/FluoroPharma.

The other authors declare that they have no conflict of interest.

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