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J Nucl Med. 2008; 49 (Supplement 1):368P
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Oncology-Clinical Diagnosis: Solid Tumors

Clinical Diagnosis-Solid Tumors Posters

The high diagnostic value of F-18 FDOPA PET and PET-CT in pheochromocytoma

Farzin Imani1, Vatche Agopian2, Martin Walter1, Firoozeh Imani1, Matthias Benz1, Rebecca Dumont1, Michael Phelps1, Johannes Czernin1 and Michael Yeh2

1 Pharmacology; 2 Surgery, University of California at Los Angeles, Los Angeles, California

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Objectives: Clinical suspicion of pheochromocytoma requires accurate diagnosis and localization of tumors. Herein, we investigated the diagnostic accuracy of positron emission tomography (PET) using 3,4-dihydroxy-6-[18F]fluoro-phenylalanine (18F-DOPA), a norepinephrine transporter substrate for detection of pheochromocytomas.

Methods: Patients with clinically suspected pheochromocytoma were selected. All patients received standardized whole-body PET or PET/CT with a median of 540MBq (range: 206-625MBq) 18F-DOPA. All scans were analyzed visually and quantitatively (SUVmax and maximal transverse diameter) by two readers blinded to the clinical data. Histology and long-term clinical follow up served as gold standard.

Results: 21 consecutive patients (8m, 13f, mean age 47.2±11y) were included. Histology confirmed pheochromocytoma in 9 cases and nonchromaffin cell tumors in 3 cases (adrenal cortical adenoma, Castleman's disease, metastatic mucinous adenocarcinoma of lung primary). The diagnosis of pheochromocytoma was established by follow up in 2 and ruled out in 7 patients. Eleven patients had 18F-DOPA PET and 10 patients had 18F-DOPA PET/CT studies. Visual analysis detected and localized pheochromocytoma in 9 of 11 patients without false positive results (sensitivity: 81.8%, specificity: 100%, accuracy: 90.5%). These lesions had an SUVmax of 2.3-34.9 (mean: 12.9) and a maximal diameter of 33-87mm (mean: 56mm). Evaluation of the false negative cases revealed a 13x5mm lesion with SUVmax of 1.96 in one case; no lesion was localized in the second case using multiple additional modalities.

Conclusions: 18F-DOPA PET and PET/CT are highly sensitive and specific tools for diagnostic work-up in suspected pheochromocytoma.





This Article
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Right arrow Alert me to new issues of the journal
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Google Scholar
Right arrow Articles by Imani, F.
Right arrow Articles by Yeh, M.
PubMed
Right arrow Articles by Imani, F.
Right arrow Articles by Yeh, M.