Characterization of neuroblastic tumors using 18F-FDOPA PET
Journal
Journal of Nuclear Medicine
Journal Volume
54
Journal Issue
1
Pages
42-49
Date Issued
2013
Author(s)
Liu 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.
KAI-YUAN TZEN
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 ? 2013 by the Society of Nuclear Medicine and Molecular Imaging, Inc.
SDGs
Other Subjects
(3 iodobenzyl)guanidine i 123; 6 fluorodopa f 18; amino acid decarboxylase; catecholamine; fluorodeoxyglucose f 18; messenger RNA; accuracy; amino acid decarboxylase gene; article; catecholamine metabolism; cell viability; clinical article; diagnostic imaging; diagnostic test accuracy study; diagnostic value; drug excretion; drug uptake; false negative result; false positive result; female; follow up; ganglioneuroma; gene expression; histopathology; human; human tissue; image analysis; infant; male; neuroblastoma; positron emission tomography; priority journal; protein expression; scintigraphy; sensitivity and specificity; tumor cell; 3-Iodobenzylguanidine; Biological Transport; Carboxy-Lyases; Catecholamines; Dihydroxyphenylalanine; Female; Fluorodeoxyglucose F18; Gene Expression Regulation, Neoplastic; Humans; Infant; Male; Neuroblastoma; Positron-Emission Tomography; Retrospective Studies; Sensitivity and Specificity; Vanilmandelic Acid
Type
journal article