嗜铬细胞瘤是由嗜铬细胞引起的肾上腺内交感神经内分泌肿瘤。副神经节瘤同样来自嗜铬细胞,尽管在肾上腺外部位,如腹部/胸部的交感神经节旁,或副交感神经节旁在头/颈部。总的来说,嗜铬细胞瘤和副神经节瘤对诊断和切除很重要,因为它们可能分泌有害水平的儿茶酚胺,有质量效应,出血,和/或转移。嗜铬细胞瘤的解剖成像通常通过计算机断层扫描或磁共振成像完成;然而,功能成像可用于提供额外的定位,分期,和/或生物信息。因此,选择合适的功能成像模式对于制定最佳治疗策略至关重要.68Galli-和64铜-1,4,7,10-四氮杂环十二烷-1,4,7,10-四乙酸(DOTA)-奥曲酯正电子发射断层扫描计算机断层扫描(68Ga-和64Cu-DOTATATE)广泛用于评估嗜铬细胞瘤和副神经节瘤,尽管关于诊断嗜铬细胞瘤的敏感性的数据有限。我们报告了2例嗜铬细胞瘤,这些嗜铬细胞瘤显示出非诊断性68Ga-DOTATATE摄取,但随后使用其他功能成像方式进行了可视化。此外,我们对文献进行了综述,以强调基于生长抑素的化合物的功能性肾上腺成像的不足.
Pheochromocytomas are intra-adrenal sympathetic neuroendocrine tumors that arise from chromaffin cells. Paragangliomas similarly arise from chromaffin cells, although at extra-adrenal sites such as sympathetic paraganglia in the abdomen/thorax, or parasympathetic paraganglia in the head/neck. Collectively, pheochromocytomas and paragangliomas are important to diagnose and resect because they may secrete harmful levels of catecholamines, have mass effects, hemorrhage, and/or metastasize. Anatomic imaging of pheochromocytomas is usually completed with computed tomography or magnetic resonance imaging; however, functional imaging may be used to provide additional localization, staging, and/or biologic information. Accordingly, selection of the proper functional imaging modality can be critical to developing the optimal therapeutic strategy. 68Gallium- and 64Copper-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA)-octreotate positron emission tomography computed tomography (68Ga- and 64Cu-DOTATATE) are widely used in evaluating pheochromocytomas and paragangliomas, although data regarding the sensitivity for diagnosing pheochromocytoma are limited. We report 2 cases of pheochromocytoma that showed nondiagnostic 68Ga-DOTATATE uptake but were subsequently visualized using alternative functional imaging modalities. Additionally, we provide a review of the literature to highlight the underappreciated limitations of functional adrenal imaging with somatostatin-based compounds.