| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | RSS | TABLE OF CONTENTS |
|
|
|
||||||||
|
||||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Clinical Investigation |
1 Reproductive Biology and Medicine Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; 2 Department of Endocrinology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; 3 Nuclear Medicine Department, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland; 4 Department of Diagnostic Radiology, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland; and 5 Clinical Neurocardiology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
Correspondence: For correspondence or reprints contact: Karel Pacak, MD, PhD, DSc, Reproductive Biology and Medicine Branch, National Institute of Child Health and Human Development, 10 Center Dr., Bldg. 10, CRC, RM 1-E 3140, MSC 1109, Bethesda, MD 20892-1109. E-mail: karel{at}mail.nih.gov
6-18F-fluoro-L-3,4-dihydroxyphenylalanine (18F-DOPA) PET is a useful tool for the detection of certain neuroendocrine tumors, especially with the preadministration of carbidopa, an inhibitor of DOPA decarboxylase. Whether carbidopa also improves 18F-DOPA PET of adrenal pheochromocytomas and extraadrenal paragangliomas is unknown. The aim of this study was to investigate the sensitivity of 18F-DOPA PET in the detection of paraganglioma and its metastatic lesions and to evaluate whether tracer uptake by the tumors is enhanced by carbidopa. Methods: Two patients with nonmetastatic adrenal pheochromocytoma, and 9 patients with extraadrenal abdominal paraganglioma (1 nonmetastatic, 8 metastatic), underwent whole-body CT, MRI, baseline 18F-DOPA PET, and 18F-DOPA PET with oral preadministration of 200 mg of carbidopa. The dynamics of tracer uptake by these lesions and the physiologic distribution of 18F-DOPA in normal tissues were recorded. Results: Seventy-eight lesions were detected by CT or MRI, 54 by baseline 18F-DOPA PET (P = 0.0022 vs. CT/MRI), and 57 by 18F-DOPA PET plus carbidopa (P = 0.0075 vs. CT/MRI, not statistically significant vs. baseline). In reference to findings on CT and MRI, the sensitivities of baseline 18F-DOPA PET were 47.4% for lesions and 55.6% for positive body regions, versus 50.0% (lesions) and 66.7% (regions) for 18F-DOPA PET plus carbidopa (neither is statistically significant vs. baseline). Compared with baseline, carbidopa detected additional lesions in 3 (27%) of 11 patients. Carbidopa increased the mean (±SD) peak standardized uptake value in index tumor lesions from 6.4 ± 3.9 to 9.1 ± 5.6 (P = 0.037). Pancreatic physiologic 18F-DOPA uptake, which may mask adrenal pheochromocytoma, is blocked by carbidopa. Conclusion: Carbidopa enhances the sensitivity of 18F-DOPA PET for adrenal pheochromocytomas and extraadrenal abdominal paragangliomas by increasing the tumor-to-background ratio of tracer uptake. The sensitivity of 18F-DOPA PET for metastases of paraganglioma appears to be limited.
Key Words: 6-fluoro-DOPA • 6-18F-fluorodopamine • carbidopa • pheochromocytoma • paraganglioma • positron emission tomography • standardized uptake value • region of interest
COPYRIGHT © 2007 by the Society of Nuclear Medicine, Inc.
Related articles in JNM:
This article has been cited by other articles:
|
|
 |
|
  L. Tessonnier, F. Sebag, C. Ghander, C. De Micco, R. Reynaud, F. F. Palazzo, B. Conte-Devolx, J. F. Henry, O. Mundler, and D. Taieb Limited Value of 18F-F-DOPA PET to Localize Pancreatic Insulin-Secreting Tumors in Adults with Hyperinsulinemic Hypoglycemia J. Clin. Endocrinol. Metab., January 1, 2010; 95(1): 303 - 307. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. J. L. M. Timmers, C. C. Chen, J. A. Carrasquillo, M. Whatley, A. Ling, B. Havekes, G. Eisenhofer, L. Martiniova, K. T. Adams, and K. Pacak Comparison of 18F-Fluoro-L-DOPA, 18F-Fluoro-Deoxyglucose, and 18F-Fluorodopamine PET and 123I-MIBG Scintigraphy in the Localization of Pheochromocytoma and Paraganglioma J. Clin. Endocrinol. Metab., December 1, 2009; 94(12): 4757 - 4767. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.-B. Fiebrich, A. H. Brouwers, M. N. Kerstens, M. E. J. Pijl, I. P. Kema, J. R. de Jong, P. L. Jager, P. H. Elsinga, R. A. J. O. Dierckx, J. E. van der Wal, et al. 6-[F-18]Fluoro-L-Dihydroxyphenylalanine Positron Emission Tomography Is Superior to Conventional Imaging with 123I-Metaiodobenzylguanidine Scintigraphy, Computer Tomography, and Magnetic Resonance Imaging in Localizing Tumors Causing Catecholamine Excess J. Clin. Endocrinol. Metab., October 1, 2009; 94(10): 3922 - 3930. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Imani, V. G. Agopian, M. S. Auerbach, M. A. Walter, F. Imani, M. R. Benz, R. A. Dumont, C. K. Lai, J. G. Czernin, and M. W. Yeh 18F-FDOPA PET and PET/CT Accurately Localize Pheochromocytomas J. Nucl. Med., April 1, 2009; 50(4): 513 - 519. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Kauhanen, M. Seppanen, J. Ovaska, H. Minn, J. Bergman, P. Korsoff, P. Salmela, J. Saltevo, T. Sane, M. Valimaki, et al. The clinical value of [18F]fluoro-dihydroxyphenylalanine positron emission tomography in primary diagnosis, staging, and restaging of neuroendocrine tumors Endocr. Relat. Cancer, March 1, 2009; 16(1): 255 - 265. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Nanni, S. Fanti, and D. Rubello 18F-DOPA PET and PET/CT J. Nucl. Med., October 1, 2007; 48(10): 1577 - 1579. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | RSS | TABLE OF CONTENTS |
| JOURNAL OF NUCLEAR MEDICINE TECHNOLOGY | THE JOURNAL OF NUCLEAR MEDICINE |
