Nuclear medicine and perspective thoughts in the diagnosis and treatment of pheochromocytoma and paraganglioma.

Pheochromocytoma and paraganglioma (PPGL) are rare and life-threatening tumors of the adrenal medulla and extra-adrenal paraganglia, respectively. Management of PPGL depends on accurate diagnosis and treatment. This review provides a very comprehensive overview of nuclear medicine in PPGL with some of our perspective views on diagnostic challenges and pitfalls, treatment, and new phase studies. It describes nuclear medicine techniques including 64Cu/68Ga-DOTA-SSA, 18F-FDOPA, 18F-FDG, 123I-MIBG, and some emerging molecular imaging agents and PRRT therapies, such as 203Pb VMT-α-NET and 212Pb VMT-α-NET targeted alpha therapy (TAT). It also provides insight into the use of proliferating cell nuclear antigen (PCNA) inhibitors in combination with therapeutics in aggressive/metastatic PPGL. Through a comprehensive review of the latest developments and clinical practice, this review aims to guide healthcare professionals in improving the diagnostic accuracy and therapeutic efficacy of PPGL.