Imaging of pheochromocytoma and paraganglioma

With improvements in genetics and oncology, and increased cross-sectional imaging, there is rapid expansion in the existing knowledge regarding diagnosis and management of pheochromocytomas and paragangliomas (PPGL). According to the 2017 World Health Organization (WHO) Classification of Tumors of Endocrine Organs, genetic cancer susceptibility is more frequent in endocrine cancers, especially PPGL cancers. Imaging plays an important role in the diagnosis and staging of disease, as well as part of surveillance in the heritable syndromes. In this chapter, we review the imaging characteristics of PPGL, under both anatomic and physiologic imaging modalities, supported with multiple clinical examples. We allude to the role of imaging in specific scenarios, such as genetic syndromes, and describe some of the relevant recent advances particularly as related to physiologic imaging.