Toward tailored medicine (and beyond): the phaeochromocytoma and paraganglioma model

Using the PCC (phaeochromocytomas)/PGL (paragangliomas) as the model, Cuccurullo and Mansi discuss whether new better performing radio-compounds necessarily determine the disappearance of the older ones. 123I MIBG remains the first choice when the presence of a PCC or a PGL is suspected. 68Ga-DOTA peptides should be considered: (a) as the first-line investigation in patients at high risk of PGL and metastatic disease, for example for screening carriers for mutations associated with familial PGL syndromes; (b) as the next investigation if 123I-MIBG does not detect lesions in patients with a high pretest probability of PCC or PGL; and (c) in preference to 123I-MIBG if metastatic spread, particularly to the bone, is suspected.