Increased urine/plasma levels of metanephrines secure the diagnosis of phaeochromocytma (PHAEO) and paraganglioma (PGGL). MIBG scanning can be utilised for diagnosis in patients with minimal biochemical abnormalities and to identify metastatic disease. The overall radiation exposure from MIBG is estimated to be 17mSv, equivalent to around 6 years background radiation exposure. The cost of the scan is approximately £1000 and requires 2 days hospital attendance.

Retrospective review of patients operated for PHAEO/PGGL in a tertiary referral centre.

Between 2001-2020, a total of 208 patients (94M:113F, age 51±16 years) had laparoscopic (n= 170) and open surgery (n=38) for PHAEO (n= 192) and PGGL (n= 16). Genetic screening was performed in 125 patients, of whom 38 (30%) were found to have pathogenic mutations. There was no difference in preoperative characteristics between patients who had an MIBG scan (n=103), and those who did not (n=70), in terms of median age (49 vs 53 years), normetanephrines (14 vs 8 umol/24h), size of tumour (52±23mm vs. 60±34mm) and extraadrenal location of primary tumour (4/70 vs. 8/103, respectively). During median follow-up of 49 months (IQR 17-67 months), recurrence was diagnosed in 13 patients at median 54 months (IQR 37- 65) following surgery and it was unrelated to initial MIBG status.

Routine MIBG scanning does not alter overall operative outcome and is of no apparent benefit in all patients presenting with PHEO/PGGL. Judicious use of this test has a significant financial and time saving benefit with no negative impact on patients' care