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

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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 languageEnglish
Pages (from-to)42-49
Number of pages8
JournalJournal of Nuclear Medicine
Volume54
Issue number1
DOIs
Publication statusPublished - Jan 2013
Externally publishedYes

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Keywords

  • F-FDOPA
  • Ganglioneuroma
  • Neuroblastoma
  • Positron emission tomography
  • Sensitivity and specificity

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Lu, M. Y., Liu, Y. L., Chang, H. H., Jou, S. T., Yang, Y. L., Lin, K. H., Lin, D. T., Lee, Y. L., Lee, H., Wu, P. Y., Luo, T. Y., Shen, L. H., Huang, S. F., Liao, Y. F., Hsu, W. M., & Tzen, K. Y. (2013). Characterization of neuroblastic tumors using 18F-FDOPA PET. Journal of Nuclear Medicine, 54(1), 42-49. https://doi.org/10.2967/jnumed.112.102772