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Oncology-Clinical Diagnosis: Solid TumorsClinical Diagnosis-Solid Tumors Posters |
1 Medecine Nucleaire, Hopital Tenon, Paris, France
1545
Objectives: The discovery of ectopic production of ACTH raises the challenge of the localisation of the primary tumour site of production and of the detection of potential metastatic sites. Somatostatin receptor scintigraphy (SRS) and FDG PET are being used in this aim. It has more recently been shown that FDOPA PET has better diagnostic performances in selected endocrine tumours. We aimed to evaluate the potential role of FDOPA PET/CT, alone or in association with SRS and/or FDG PET, for the detection of these endocrine tumours.
Methods: Between May 2003 and July 2007, 10 examinations have been performed in 9 patients for localisation of ectopic ACTH-secreting endocrine tumours.
Results: At the time of FDOPA PET/CT, SRS had been performed in 8 patients and was negative in 6 and doubtful in 2 (questionable uptake in the breast in one case and in the mediastinum in the other case). FDG PET had been performed in only 2 patients and was negative. FDOPA PET/CT was negative in 7 patients and positive in 2. In one patient, a significant focus of FDOPA uptake was seen in a mediastinal lymph node (without anomaly of CT and SRS but positivity in the same site of FDG PET, performed after FDOPA PET) leading to surgery, confirming the endocrine tumour involvement of a normal sized lymph node. In the other case, FDOPA PET showed a focus in the gut but all the subsequent imaging work-up was negative and a second FDOPA PET/CT was negative 10 months later.
Conclusions: FDOPA PET/CT seemed not to be suited to detect the occult primary ACTH producing tumour when SRS is non conclusive. FDG PET/CT gave the same information in the only positive case for whom only one metastatic lesion was detected.
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