Interesting ImagesMultifocal Urinary Bladder Paragangliomas With Negative 68Ga-DOTATATE Uptake and Positive 123I-MIBG UptakeParra, Laura A. MD, MPH*; Swanson, Scott K. MD†; Salomao, Marcela A. MD‡; Yang, Ming MD*Author Information From the Departments of *Radiology †Urology ‡Pathology, Mayo Clinic Arizona, Scottsdale, AZ. Received for publication July 6, 2019; revision accepted September 6, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Ming Yang, MD, 13400 E Shea Blvd, Scottsdale, AZ 85259. E-mail: firstname.lastname@example.org. Online date: November 11, 2019 Clinical Nuclear Medicine: March 2020 - Volume 45 - Issue 3 - p e156-e157 doi: 10.1097/RLU.0000000000002853 Buy Metrics Abstract We report a case of an adult male patient with multifocal urinary bladder paragangliomas, which were negative on 68Ga-DOTATATE PET/CT scan, but positive on 123I-MIBG SPECT/CT scan. While the 68Ga-DOTA analog PET/CT exhibits superior performance in diagnosis and staging of pheochromocytoma and paraganglioma, our case demonstrates negative somatostatin receptor expression in this rare entity and indicates that 123I-MIBG SPECT/CT still plays a vital role in characterization of bladder paraganglioma. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.