Characterization of Neuroblastic Tumors Using 18F-FDOPA PET

Journal of Nuclear Medicine

Yen-Lin Liu¹  Wen-Ming Hsu¹  Shiann-Tarng Jou¹  Yung-Li Yang¹  Shiu-Feng Huang¹  Hsinyu Lee¹  Ya-Ling Lee¹  Kai-Yuan Tzen¹  Lie-Hang Shen¹  Tsai-Yueh Luo¹  Yung-Feng Liao¹  Dong-Tsamn Lin¹  Meng-Yao Lu¹  Hsiu-Hao Chang¹  Pei-Yi Wu¹  Kai-Hsin Lin¹ 

关键词: neuroblastoma;    ganglioneuroma;    ¹⁸F-FDOPA;    positron emission tomography;    sensitivity and specificity;   

DOI  :  10.2967/jnumed.112.102772

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

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 = 15 nonhepatic tumors; maximum standardized uptake value, P = 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.

【 授权许可】

Unknown