Oxidative Phosphorylation. A 20 year old male with SDHB germline mutation and metastatic PCC. Baseline Ga-68 DOTATATE (a) and F-18 FDG (b) demonstrated metastatic disease with a concordant pattern of uptake. The patient was treated with 3 cycles of peptide receptor radionuclide therapy for uncontrolled hypertension. Follow-up DOTATATE and FDG imaging over a 2 year period demonstrated stable findings (c: FDG at 2 years). The high FDG-uptake was not predictive of an aggressive phenotype and reflects changes secondary to SDHB mutation and consequent disordered oxidative phosphorylation. 68 Ga-DOTATATE and 18 F-FDG PET/CT in Paraganglioma and Pheochromocytoma: utility, patterns and heterogeneity. Chang CA,Pattison DA, Tothill RW, Kong G, Akhurst TJ, Hicks RJ, Michael S.- Cancer Imaging. (2016). Not Altered. CC.