TY - JOUR
T1 - Interlesional Heterogeneity of Metastatic Neuroendocrine Tumors Based on 18F-DOPA PET/CT
AU - de Hosson, Lotte D.
AU - van der Loo-van der Schaaf, Aline M.
AU - Boellaard, Ronald
AU - van Snick, Johannes H.
AU - de Vries, Elisabeth G. E.
AU - Brouwers, Adrienne H.
AU - Walenkamp, Annemiek M. E.
PY - 2019/8
Y1 - 2019/8
N2 - Purpose Neuroendocrine tumors (NETs) can produce neuroendocrine amines resulting in symptoms. Selecting the most active amine-producing tumor lesions for local treatment might be beneficial for patients with metastatic small intestinal NET. Tumor burden correlates with catecholamine pathway activity. We analyzed interlesional heterogeneity with F-18-DOPA PET scans in patients with small intestinal NET and investigated if lesions with substantially higher F-18-DOPA uptake could be identified. Methods In this retrospective, observational study, the F-18-DOPA uptake was calculated by dividing SUVpeak of the lesion by the SUVmean of the background organ. The magnitude of heterogeneity between lesions within a patient was calculated by dividing the lesion with the highest by the one with the lowest F-18-DOPA uptake. Lesions with a higher F-18-DOPA uptake than the upper inner or outer fence (>1.5 or 3 times the interquartile range above the third quartile) were defined as lesions with mild or extreme high F-18-DOPA uptake, respectively, and presence of these was determined in patients with 10 lesions or more. Results F-18-DOPA was detected over 680 lesions in 38 patients, of which 35 were serotonin producing. F-18-DOPA uptake varied with a median of 8-fold up to 44-fold between lesions within a patient. In 12 of 20 evaluable patients, lesions with mild high F-18-DOPA uptake were found, and in 5, lesions with extreme high F-18-DOPA uptake. Conclusions F-18-DOPA-PET showed considerable heterogeneity in F-18-DOPA uptake between tumor lesions and identified lesions within patients with mild or extreme high F-18-DOPA uptake.
AB - Purpose Neuroendocrine tumors (NETs) can produce neuroendocrine amines resulting in symptoms. Selecting the most active amine-producing tumor lesions for local treatment might be beneficial for patients with metastatic small intestinal NET. Tumor burden correlates with catecholamine pathway activity. We analyzed interlesional heterogeneity with F-18-DOPA PET scans in patients with small intestinal NET and investigated if lesions with substantially higher F-18-DOPA uptake could be identified. Methods In this retrospective, observational study, the F-18-DOPA uptake was calculated by dividing SUVpeak of the lesion by the SUVmean of the background organ. The magnitude of heterogeneity between lesions within a patient was calculated by dividing the lesion with the highest by the one with the lowest F-18-DOPA uptake. Lesions with a higher F-18-DOPA uptake than the upper inner or outer fence (>1.5 or 3 times the interquartile range above the third quartile) were defined as lesions with mild or extreme high F-18-DOPA uptake, respectively, and presence of these was determined in patients with 10 lesions or more. Results F-18-DOPA was detected over 680 lesions in 38 patients, of which 35 were serotonin producing. F-18-DOPA uptake varied with a median of 8-fold up to 44-fold between lesions within a patient. In 12 of 20 evaluable patients, lesions with mild high F-18-DOPA uptake were found, and in 5, lesions with extreme high F-18-DOPA uptake. Conclusions F-18-DOPA-PET showed considerable heterogeneity in F-18-DOPA uptake between tumor lesions and identified lesions within patients with mild or extreme high F-18-DOPA uptake.
KW - F-18-DOPA PET scan
KW - heterogeneity
KW - neuroendocrine tumor
KW - tracer uptake
KW - LIVER-METASTASES
KW - CARCINOID-TUMORS
KW - GUIDELINES
U2 - 10.1097/RLU.0000000000002640
DO - 10.1097/RLU.0000000000002640
M3 - Article
VL - 44
SP - 612
EP - 619
JO - Clinical Nuclear Medicine
JF - Clinical Nuclear Medicine
SN - 0363-9762
IS - 8
ER -