Use of 6-[18F]-fluorodopamine positron emission tomography (PET) as first-line investigation for the diagnosis and localization of non-metastatic and metastatic phaeochromocytoma (PHEO)

Clin Endocrinol (Oxf). 2009 Jul;71(1):11-7. doi: 10.1111/j.1365-2265.2008.03496.x. Epub 2008 Dec 5.


Objective: Imaging modalities available for the localization of phaeochromocytoma (PHEO) include computed tomography (CT), magnetic resonance imaging (MRI), [(123)I]- or [(131)I]-labelled metaiodobenzylguanidine ((123/131)I-MIBG) scintigraphy and 6-[(18)F]-fluorodopamine ((18)F-FDA) positron emission tomography (PET). Our aim was to investigate the yield of (18)F-FDA PET vs. biochemical testing and other imaging techniques to establish the diagnosis and location of PHEO.

Patients and measurements: The study included 99 consecutive patients (35 Males, 64 Females, mean +/- SD age 46.4 +/- 13.4 years), who underwent (18)F-FDA PET, biochemical testing (plasma catecholamines and free metanephrines) and CT and/or MRI. The majority (78%) also underwent (123/131)I-MIBG.

Results: In total 26 patients had non-metastatic PHEO, 34 patients had metastatic PHEO, and PHEO was ruled out in 39 patients. Investigations to rule out or confirm PHEO yielded the following sensitivity/specificity: plasma metanephrines 97/95%, (18)F-FDA 92/90%, (123)I-MIBG 83/100%, (123/131)I-MIBG 70/100%, CT 100/41%, MRI 98/60%. Sensitivities for localizing non-metastatic PHEO on a per-lesion base were: CT 97%, MRI 92%, (18)F-FDA 78%, (123)I-MIBG 78% and (123/131)I-MIBG 76%. Sensitivities for detecting metastases on a per-patient base were: CT and MRI 100%, (18)F-FDA 97%, (123)I-MIBG 85% and (123/131)I-MIBG 65%.

Conclusion: For tumour localization, (18)F-FDA PET and (123/131)I-MIBG scintigraphy perform equally well in patients with non-metastatic PHEO, but metastases are better detected by (18)F-FDA PET than by (123/131)I-MIBG.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Dopamine / analogs & derivatives*
  • Dopamine / chemistry
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Neoplasm Staging / methods*
  • Pheochromocytoma / diagnosis*
  • Pheochromocytoma / diagnostic imaging
  • Pheochromocytoma / pathology
  • Positron-Emission Tomography / methods*


  • 6-fluorodopamine
  • Dopamine