engleski

F-18 DOPA PET/CT in patients with neuroendocrine tumors

The aim of this study was to examine and study the impact of F-18 DOPA PET/CT imaging in patients with medullary carcinoma and other neuroendocrine tumors. Materials andMethods: Twenty patients were referred to our Department for staging or restaging neuroendocrine tumors. They were scanned with F-18 dihydroxyphenylalanine (DOPA) PET/CT from November of 2012 to January 2015. In 13 of our patients, medullary carcinoma was diagnosed at least 11 months earlier ; mean period from diagnosis to PET/CT was 5 years. Other neuroendocrine tumorswere diagnosed in 7 patients (threewith insulinoma, two with paragangliomas, one had pheochromocytoma and in one patient undefined NET was suspected). Because of elevation of tumor markers and/or equivocal findings of morphological imaging methods (i.e. ultrasound, MSCT or MRI), functional diagnostic imaging was proposed. The mean follow up period was 11.3 months. Results: An increased abnormal F-18 DOPA uptake was found in 12 patients (60%). In 9 out of 13 medullary carcinoma patients, a positive finding was reported, mostly due to metabolically active metastases in neck and mediastinal lymph nodes. Mean SUV value was 5.5, ranging from 2.6 to 9.5. Three patients referred with other NET diagnoses had a positive DOPA PET/CTscans and were spared further diagnostic procedures and unnecessary treatments. Two patients benefited greatly from an F-18 DOPA scan, as they were completely cured after surgical resection (one with insulinoma and one more with paraganglioma). Comparing with other imaging modalities used in our patient population (CT, MR, bone scintigraphy, Octreoscan, or Tc-99m- DMSAV scintigraphy), F-18 DOPAwas found to be the most sensitive in discovering various disease locations, especially for medullary carcinoma.After F-18-DOPA PET/CTscan, surgical extraction of metabolically active tissues was performed , in seven patients. Conclusions: F-18-DOPA PET/CT is a novel, still emerging molecular diagnostic imaging method for staging and restaging neuroendocrine tumors. Both positive and negative scan findingswere of significant use in our patient’s further management, modifying therapy options to better suit the needs of each patient individually.

F-18-DOPA ; neuroendocrine tumors ; PET/CT

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