Fig. 7.

Schematic overview of the Pheochromocytoma of the Adrenal gland Scaled Score (PASS) and the Grading System for Adrenal Pheochromocytoma and Paraganglioma (GAPP) algorithms. Including parameters are listed, as well as the individual points given for each fulfilled criteria. Bottom row depicts the high negative predictive value of both algorithms as suggested by a recent meta-analysis, indicating that low PASS/GAPP scores are strongly associated to benign clinical courses, while elevated PASS/GAPP scores are recurrently reported in metastatic-free PPGLs—thereby limiting the value of these algorithms as “rule-in” tests. P point, E epinephrine, NP non-producing, NE norepinephrine