Fig. 3.

Multimodality imaging in a spinal bone metastatic pheochromocytoma/paraganglioma participant with spinal hardware. The images of sagittal short tau inversion recovery (STIR, a) MRI, contrast-enhanced CT (b sagittal), fused sagittal ⁶⁸Ga-DOTA(0)-Tyr(3)-octreotate ([⁶⁸Ga]DOTATATE; c, d images at two different sagittal planes) PET/CT, and fused sagittal ¹⁸F-fluoro-2-deoxy-d-glucose ([¹⁸F]FDG PET/CT; e, f images at the same two sagittal planes as [⁶⁸Ga]DOTATATE PET/CT) focused on thoracic spine of a 48-year-old woman with negative germline testing in pheochromocytoma and paraganglioma susceptibility genes are shown. This participant had spinal hardware placed at the T5–T9 vertebrae which therefore were excluded from the analysis due to the associated artifacts on MRI and CT. However, PET/CT imaging clearly is advantageous in the evaluation of patients with spinal bone hardware as demonstrated by the spinal bone metastases at T7–T9 on [⁶⁸Ga]DOTATATE PET/CT (arrows) and at T7 and T9 on [¹⁸F]FDG PET/CT (arrows), where spinal hardware is placed. The uptake on [¹⁸F]FDG PET/CT is comparatively much fainter compared to [⁶⁸Ga]DOTATATE PET/CT. This participant did not undergo whole-body MRI