Functional characterization of nonmetastatic paraganglioma and pheochromocytoma by 18F-FDOPA PET: focus on missed lesions

Summary Aims and methods To evaluate the clinical value of 18F‐fluorodihydroxyphenylalanine (18F‐FDOPA) PET in relation to tumour localization and the patient's genetic status in a large series of pheochromocytoma/paraganglioma (PHEO/PGL) patients and to discuss in detail false‐negative results. A retrospective study of PGL patients who were investigated with 18F‐FDOPA PET or PET/CT imaging in two academic endocrine tumour centres was conducted (La Timone University Hospital, Marseilles, France and National Institutes of Health (NIH), Bethesda, MD, USA). Results One hundred sixteen patients (39·7% harbouring germline mutations in known disease susceptibility genes) were evaluated for a total of 195 PHEO/PGL foci. 18F‐FDOPA PET correctly detected 179 lesions (91·8%) in 107 patients (92·2%). Lesion‐based sensitivities for parasympathetic PGLs (head, neck, or anterior/middle thoracic ones), PHEOs, and extra‐adrenal sympathetic (abdominal or posterior thoracic) PGLs were 98·2% [96·5% for Timone and 100% for NIH], 93·9% [93·8 and 93·9%] and 70·3% [47·1 and 90%] respectively (P