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6-L-¹⁸F-Fluorodihydroxyphenylalanine PET in Neuroendocrine Tumors: Basic Aspects and Emerging Clinical Applications^*

¹ Department of Nuclear Medicine, Hamilton Health Sciences/McMaster University, Hamilton, Ontario, Canada; and ² Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands

Correspondence: For correspondence or reprints contact: Pieter L. Jager, MD, PhD, Department of Nuclear Medicine, Hamilton Health Sciences/McMaster University, 1200 Main St. West, Hamilton, Ontario L8N 3Z5, Canada. E-mail: jager{at}hhsc.ca

In recent years, 6-L-¹⁸F-fluorodihydroxyphenylalanine (¹⁸F-DOPA) PET has emerged as a new diagnostic tool for the imaging of neuroendocrine tumors. This application is based on the unique property of neuroendocrine tumors to produce and secrete various substances, a process that requires the uptake of metabolic precursors, which leads to the uptake of ¹⁸F-DOPA. This nonsystematic review first describes basic aspects of ¹⁸F-DOPA imaging, including radiosynthesis, factors involved in tracer uptake, and various aspects of metabolism and imaging. Subsequently, this review provides an overview of current clinical applications in neuroendocrine tumors, including carcinoid tumors, pancreatic islet cell tumors, pheochromocytoma, paraganglioma, medullary thyroid cancer, hyperinsulinism, and various other clinical entities. The application of PET/CT in carcinoid tumors has unsurpassed sensitivity. In medullary thyroid cancer, pheochromocytoma, and hyperinsulinism, results are also excellent and contribute significantly to clinical management. In the remaining conditions, the initial experience with ¹⁸F-DOPA PET indicates that it seems to be less valuable, but further study is required.

Key Words: ¹⁸F-DOPA • PET • neuroendocrine tumors • carcinoid

^* NOTE: FOR CE CREDIT, YOU CAN ACCESS THIS ACTIVITY THROUGH THE SNM WEB SITE (http://www.snm.org/ce_online) THROUGH APRIL 2009.

No potential conflict of interest relevant to this article was reported. This paper discusses investigational devices/drugs not yet approved by the FDA.

COPYRIGHT © 2008 by the Society of Nuclear Medicine, Inc.

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