Characterization of neuroblastic tumors using 18F-FDOPA PET

Meng Yao Lu; Yen Lin Liu; Hsiu Hao Chang; Shiann Tarng Jou; Yung Li Yang; Kai Hsin Lin; Dong Tsamn Lin; Ya Ling Lee; Hsinyu Lee; Pei Yi Wu; Tsai Yueh Luo; Lie Hang Shen; Shiu Feng Huang; Yung Feng Liao; Wen Ming Hsu; Kai Yuan Tzen

doi:10.2967/jnumed.112.102772

Characterization of neuroblastic tumors using ¹⁸F-FDOPA PET

Meng Yao Lu, Yen Lin Liu, Hsiu Hao Chang, Shiann Tarng Jou, Yung Li Yang, Kai Hsin Lin, Dong Tsamn Lin, Ya Ling Lee, Hsinyu Lee, Pei Yi Wu, Tsai Yueh Luo, Lie Hang Shen, Shiu Feng Huang, Yung Feng Liao, Wen Ming Hsu, Kai Yuan Tzen

Research output: Contribution to journal › Article › peer-review

44 Citations (Scopus)

Abstract

Neuroblastic tumors are childhood neoplasms that possess amino acid decarboxylase (AADC) activity and can theoretically be imaged by ¹⁸F-fluorodihydroxyphenylalanine (¹⁸F-FDOPA) PET, a new diagnostic tool for neuroendocrine tumors. In this study, we explored the accuracy and clinical role of ¹⁸F-FDOPA PET in neuroblastic tumors. Methods: From 2008 to 2011, patients with tissue-proven neuroblastic tumors receiving ¹⁸F-FDOPA PET at initial diagnosis or during follow-ups were enrolled. The sensitivity and specificity of ¹⁸F-FDOPA PET were compared with those of ¹²³I-metaiodobenzylguanidine ( ¹²³I-MIBG) scintigraphy and ¹⁸F-FDG PET, using tumor histology as the standard. The maximum standardized uptake value and tumor-to-liver uptake ratio on ¹⁸F-FDOPA PET were measured and correlated with AADC messenger RNA level in tumor tissue. Results: Fifty tumors from 34 patients, including 42 neuroblastic tumors and 8 lesions without viable tumor cells, were eligible for analysis. ¹⁸F-FDOPA PET successfully detected neuroblastic tumors of different histologic types in various anatomic sites, at a sensitivity of 97.6% (87.4%- 99.9%) and a specificity of 87.5% (47.3%-99.7%). In tumors with concomitant studies, ¹⁸F-FDOPA PET demonstrated a higher sensitivity than ¹²³I-MIBG scintigraphy (n = 18; P = 0.0455) or ¹⁸F-FDG PET (n = 46; P = 0.0455). Among the 18 tumors with concomitant 123I- MIBG scans, 4 tumors with viable cells were ¹²³I-MIBG-negative but were successfully detected by ¹⁸F-FDOPA PET. The tumor uptake of ¹⁸F-FDOPA significantly correlated with AADC expression (n 5 15 nonhepatic tumors; maximum standardized uptake value, P 5 0.0002; tumor-to-liver uptake ratio, P < 0.0001). Conclusion: ¹⁸F- FDOPA PET showed high sensitivity and specificity in detecting and tracking neuroblastic tumors in this preliminary study with a small cohort of patients and might be complementary to ¹²³I-MIBG scintigraphy and ¹⁸F-FDG PET. By correlating with AADC expression, ¹⁸F-FDOPA PET might serve as a useful imaging tool for the functional assessment of neuroblastic tumors. COPYRIGHT

Original language	English
Pages (from-to)	42-49
Number of pages	8
Journal	Journal of Nuclear Medicine
Volume	54
Issue number	1
DOIs	https://doi.org/10.2967/jnumed.112.102772
Publication status	Published - Jan 2013
Externally published	Yes

Keywords

F-FDOPA
Ganglioneuroma
Neuroblastoma
Positron emission tomography
Sensitivity and specificity

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging

Access to Document

10.2967/jnumed.112.102772

Cite this

@article{3e716f39d2c34989a27eec14dd343aa6,

title = "Characterization of neuroblastic tumors using 18F-FDOPA PET",

abstract = "Neuroblastic tumors are childhood neoplasms that possess amino acid decarboxylase (AADC) activity and can theoretically be imaged by 18F-fluorodihydroxyphenylalanine (18F-FDOPA) PET, a new diagnostic tool for neuroendocrine tumors. In this study, we explored the accuracy and clinical role of 18F-FDOPA PET in neuroblastic tumors. Methods: From 2008 to 2011, patients with tissue-proven neuroblastic tumors receiving 18F-FDOPA PET at initial diagnosis or during follow-ups were enrolled. The sensitivity and specificity of 18F-FDOPA PET were compared with those of 123I-metaiodobenzylguanidine ( 123I-MIBG) scintigraphy and 18F-FDG PET, using tumor histology as the standard. The maximum standardized uptake value and tumor-to-liver uptake ratio on 18F-FDOPA PET were measured and correlated with AADC messenger RNA level in tumor tissue. Results: Fifty tumors from 34 patients, including 42 neuroblastic tumors and 8 lesions without viable tumor cells, were eligible for analysis. 18F-FDOPA PET successfully detected neuroblastic tumors of different histologic types in various anatomic sites, at a sensitivity of 97.6% (87.4%- 99.9%) and a specificity of 87.5% (47.3%-99.7%). In tumors with concomitant studies, 18F-FDOPA PET demonstrated a higher sensitivity than 123I-MIBG scintigraphy (n = 18; P = 0.0455) or 18F-FDG PET (n = 46; P = 0.0455). Among the 18 tumors with concomitant 123I- MIBG scans, 4 tumors with viable cells were 123I-MIBG-negative but were successfully detected by 18F-FDOPA PET. The tumor uptake of 18F-FDOPA significantly correlated with AADC expression (n 5 15 nonhepatic tumors; maximum standardized uptake value, P 5 0.0002; tumor-to-liver uptake ratio, P < 0.0001). Conclusion: 18F- FDOPA PET showed high sensitivity and specificity in detecting and tracking neuroblastic tumors in this preliminary study with a small cohort of patients and might be complementary to 123I-MIBG scintigraphy and 18F-FDG PET. By correlating with AADC expression, 18F-FDOPA PET might serve as a useful imaging tool for the functional assessment of neuroblastic tumors. COPYRIGHT",

keywords = "F-FDOPA, Ganglioneuroma, Neuroblastoma, Positron emission tomography, Sensitivity and specificity",

author = "Lu, {Meng Yao} and Liu, {Yen Lin} and Chang, {Hsiu Hao} and Jou, {Shiann Tarng} and Yang, {Yung Li} and Lin, {Kai Hsin} and Lin, {Dong Tsamn} and Lee, {Ya Ling} and Hsinyu Lee and Wu, {Pei Yi} and Luo, {Tsai Yueh} and Shen, {Lie Hang} and Huang, {Shiu Feng} and Liao, {Yung Feng} and Hsu, {Wen Ming} and Tzen, {Kai Yuan}",

year = "2013",

month = jan,

doi = "10.2967/jnumed.112.102772",

language = "English",

volume = "54",

pages = "42--49",

journal = "Journal of Nuclear Medicine",

issn = "0161-5505",

publisher = "Society of Nuclear Medicine Inc.",

number = "1",

}

TY - JOUR

T1 - Characterization of neuroblastic tumors using 18F-FDOPA PET

AU - Lu, Meng Yao

AU - Liu, Yen Lin

AU - Chang, Hsiu Hao

AU - Jou, Shiann Tarng

AU - Yang, Yung Li

AU - Lin, Kai Hsin

AU - Lin, Dong Tsamn

AU - Lee, Ya Ling

AU - Lee, Hsinyu

AU - Wu, Pei Yi

AU - Luo, Tsai Yueh

AU - Shen, Lie Hang

AU - Huang, Shiu Feng

AU - Liao, Yung Feng

AU - Hsu, Wen Ming

AU - Tzen, Kai Yuan

PY - 2013/1

Y1 - 2013/1

N2 - Neuroblastic tumors are childhood neoplasms that possess amino acid decarboxylase (AADC) activity and can theoretically be imaged by 18F-fluorodihydroxyphenylalanine (18F-FDOPA) PET, a new diagnostic tool for neuroendocrine tumors. In this study, we explored the accuracy and clinical role of 18F-FDOPA PET in neuroblastic tumors. Methods: From 2008 to 2011, patients with tissue-proven neuroblastic tumors receiving 18F-FDOPA PET at initial diagnosis or during follow-ups were enrolled. The sensitivity and specificity of 18F-FDOPA PET were compared with those of 123I-metaiodobenzylguanidine ( 123I-MIBG) scintigraphy and 18F-FDG PET, using tumor histology as the standard. The maximum standardized uptake value and tumor-to-liver uptake ratio on 18F-FDOPA PET were measured and correlated with AADC messenger RNA level in tumor tissue. Results: Fifty tumors from 34 patients, including 42 neuroblastic tumors and 8 lesions without viable tumor cells, were eligible for analysis. 18F-FDOPA PET successfully detected neuroblastic tumors of different histologic types in various anatomic sites, at a sensitivity of 97.6% (87.4%- 99.9%) and a specificity of 87.5% (47.3%-99.7%). In tumors with concomitant studies, 18F-FDOPA PET demonstrated a higher sensitivity than 123I-MIBG scintigraphy (n = 18; P = 0.0455) or 18F-FDG PET (n = 46; P = 0.0455). Among the 18 tumors with concomitant 123I- MIBG scans, 4 tumors with viable cells were 123I-MIBG-negative but were successfully detected by 18F-FDOPA PET. The tumor uptake of 18F-FDOPA significantly correlated with AADC expression (n 5 15 nonhepatic tumors; maximum standardized uptake value, P 5 0.0002; tumor-to-liver uptake ratio, P < 0.0001). Conclusion: 18F- FDOPA PET showed high sensitivity and specificity in detecting and tracking neuroblastic tumors in this preliminary study with a small cohort of patients and might be complementary to 123I-MIBG scintigraphy and 18F-FDG PET. By correlating with AADC expression, 18F-FDOPA PET might serve as a useful imaging tool for the functional assessment of neuroblastic tumors. COPYRIGHT

AB - Neuroblastic tumors are childhood neoplasms that possess amino acid decarboxylase (AADC) activity and can theoretically be imaged by 18F-fluorodihydroxyphenylalanine (18F-FDOPA) PET, a new diagnostic tool for neuroendocrine tumors. In this study, we explored the accuracy and clinical role of 18F-FDOPA PET in neuroblastic tumors. Methods: From 2008 to 2011, patients with tissue-proven neuroblastic tumors receiving 18F-FDOPA PET at initial diagnosis or during follow-ups were enrolled. The sensitivity and specificity of 18F-FDOPA PET were compared with those of 123I-metaiodobenzylguanidine ( 123I-MIBG) scintigraphy and 18F-FDG PET, using tumor histology as the standard. The maximum standardized uptake value and tumor-to-liver uptake ratio on 18F-FDOPA PET were measured and correlated with AADC messenger RNA level in tumor tissue. Results: Fifty tumors from 34 patients, including 42 neuroblastic tumors and 8 lesions without viable tumor cells, were eligible for analysis. 18F-FDOPA PET successfully detected neuroblastic tumors of different histologic types in various anatomic sites, at a sensitivity of 97.6% (87.4%- 99.9%) and a specificity of 87.5% (47.3%-99.7%). In tumors with concomitant studies, 18F-FDOPA PET demonstrated a higher sensitivity than 123I-MIBG scintigraphy (n = 18; P = 0.0455) or 18F-FDG PET (n = 46; P = 0.0455). Among the 18 tumors with concomitant 123I- MIBG scans, 4 tumors with viable cells were 123I-MIBG-negative but were successfully detected by 18F-FDOPA PET. The tumor uptake of 18F-FDOPA significantly correlated with AADC expression (n 5 15 nonhepatic tumors; maximum standardized uptake value, P 5 0.0002; tumor-to-liver uptake ratio, P < 0.0001). Conclusion: 18F- FDOPA PET showed high sensitivity and specificity in detecting and tracking neuroblastic tumors in this preliminary study with a small cohort of patients and might be complementary to 123I-MIBG scintigraphy and 18F-FDG PET. By correlating with AADC expression, 18F-FDOPA PET might serve as a useful imaging tool for the functional assessment of neuroblastic tumors. COPYRIGHT

KW - F-FDOPA

KW - Ganglioneuroma

KW - Neuroblastoma

KW - Positron emission tomography

KW - Sensitivity and specificity

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U2 - 10.2967/jnumed.112.102772

DO - 10.2967/jnumed.112.102772

M3 - Article

C2 - 23213196

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EP - 49

JO - Journal of Nuclear Medicine

JF - Journal of Nuclear Medicine

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