Functional Imaging of SDHx-Related Head and Neck Paragangliomas: Comparison of 18F-Fluorodihydroxyphenylalanine, 18F-Fluorodopamine, 18F-Fluoro-2-Deoxy-d-Glucose PET, 123I-Metaiodobenzylguanidine Scintigraphy, and 111In-Pentetreotide Scintigraphy

Rationale: Accurate diagnosis of head and neck paragangliomas is often complicated by biochemical silence and lack of catecholamine-associated symptoms, making accurate anatomical and functional imaging techniques essential to the diagnostic process. Methods: Ten patients (seven SDHD, three SDHB), with a total of 26 head and neck paragangliomas, were evaluated with anatomical and functional imaging. This study compares five different functional imaging techniques [18F-fluorodihydroxyphenylalanine (18F-FDOPA) positron emission tomography (PET), 18F-fluorodopamine (18F-FDA) PET/computed tomography (CT), 18F-fluoro-2-deoxy-d-glucose (18F-FDG) PET/CT, 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphy, and 111In-pentetreotide scintigraphy] in the localization of head and neck paragangliomas. Results: Prospectively 18F-FDOPA PET localized 26 of 26 lesions in the 10 patients, CT/magnetic resonance imaging localized 21 of 26 lesions, 18F-FDG PET/CT localized 20 of 26 lesions, 111In-pentetreotide scintigraphy ...