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Nuclear Medicine

Pheochromocytomas: Detection with 18F DOPA Whole-Body PET—Initial Results

Published Online:Feb 1 2002https://doi.org/10.1148/radiol.2222010622

Abstract

PURPOSE: To evaluate fluorine 18 (18F) dihydroxyphenylalanine (DOPA) whole-body positron emission tomography (PET) as a biochemical imaging approach for detection of pheochromocytomas.

MATERIALS AND METHODS:18F DOPA PET and magnetic resonance (MR) imaging were performed in 14 consecutive patients suspected of having pheochromocytomas (five sporadic, nine with von Hippel-Lindau disease); metaiodobenzylguanidine (MIBG) scintigraphy was performed in 12 of these patients. The individual imaging findings were assessed in consensus by specialists in nuclear medicine and radiologists blinded to the results of the other methods. The findings of the functional imaging methods were compared with those of MR imaging, the reference standard. Histologic verification could be obtained in eight patients with nine tumors.

RESULTS: Seventeen pheochromocytomas (11 solitary, three bifocal; 14 adrenal, three extraadrenal) were detected with MR imaging. 18F DOPA PET and MR imaging had concordant results in all 17 tumors. In contrast, MIBG scintigraphy had false-negative results in four patients with three adrenal tumors smaller than 2 cm and one extraadrenal tumor with a diameter of 3.6 cm. On the basis of these data, sensitivities of 100% for 18F DOPA PET and of 71% for MIBG scintigraphy were calculated. Specificity was 100% for both procedures.

CONCLUSION:18F DOPA PET is highly sensitive and specific for detection of pheochromocytomas and has potential as the functional imaging method of the future.

References

  • 1 Manger WM, Gifford RW. Pheochromocytoma: a clinical overview. In: Laragh JH, Brenner BM, eds. Hypertension: pathophysiology, diagnosis and management. New York, NY: Raven, 1995; 225-244.
    Google Scholar
  • 2 Neumann HPH, Berger DP, Sigmund G, et al. Pheochromocytomas, multiple endocrine neoplasia type 2, and von Hippel-Lindau disease. N Engl J Med 1993; 329:1531-1538.
    Medline Google Scholar
  • 3 Bravo EL. Pheochromocytoma: new concepts and future trends. Kidney Int 1991; 40:544-556.
    Medline Google Scholar
  • 4 Neumann HPH, Bender BU, Reincke M, Eggstein S, Laubenberger J, Kirste G. Adrenal sparing surgery for pheochromocytoma. Br J Surg 1999; 84:94-97.
    Google Scholar
  • 5 Quint LE, Glazer GM, Francis IR, Shapiro B, Chenevert TL. Pheochromocytoma and paraganglioma: comparison of MR imaging with CT and 131I MIBG scintigraphy. Radiology 1987; 165:89-93.
    Google Scholar
  • 6 Hoefnagel CA, Voute PA, De Kraker J, Marcuse HR. Radionuclide diagnosis of neural crest tumors using 131I metaiodobenzylguanidine. J Nucl Med 1987; 28:308-314.
    Medline Google Scholar
  • 7 Hoefnagel CA. Metaiodobenzylguanidine and somatostatin in oncology: role in the management of neural crest tumours. Eur J Nucl Med 1994; 21:561-581.
    Medline Google Scholar
  • 8 Troncore L, Rufini V. Radiolabeled metaiodobenzylguanidine in the diagnosis of neural crest tumors. In: Murray IPC, Ell PJ, eds. Nuclear medicine in clinical diagnosis and treatment. Edinburgh, Scotland: Churchill Livingstone, 1998; 843-857.
    Google Scholar
  • 9 Pearse AGE. The cytochemistry and ultrastructure of polypeptide hormone producing cells of the APUD series and the embryologic, physiologic and pathologic implications of the concept. J Histochem Cytochem 1969; 17:303-308.
    Medline Google Scholar
  • 10 Bergström M, Eriksson B, Öberg K, et al. In vivo demonstration of enzyme activity in endocrine pancreatic tumors: decarboxylation of carbon-11-DOPA to carbon-11-dopamine. J Nucl Med 1996; 37:32-37.
    Medline Google Scholar
  • 11 Luxen A, Perlmutter M, Bida GT, et al. Remote, semiautomated production of 6-[18F]fluoro-L-dopa for human studies with PET. Int J Rad Appl Instrum [A] 1990; 41:275-281.
    Medline Google Scholar
  • 12 Mix M, Nitzsche EU. PISAC: a post-injection method for segmented attenuation correction in whole-body PET. J Nucl Med 1999; 40 Sl:A 297 P.
    Google Scholar
  • 13 Reinig JW, Doppmann JL, Dwyer AJ, Johnson AR, Knop RH. Adrenal masses differentiated by MR. Radiology 1986; 158:81-84.
    Google Scholar
  • 14 Dunnick NR. Adrenal imaging: current status. AJR Am J Roentgenol 1990; 154:927-936.
    Medline Google Scholar
  • 15 Shulkin BL, Thompson NW, Shapiro B, Francis IR, Sisson JC. Pheochromocytomas: imaging with 2-[fluorine-18]fluoro-2-deoxy-d-glucose PET. Radiology 1999; 212:35-41.
    Google Scholar
  • 16 Shulkin BL, Wieland DM, Schwaiger M, et al. PET scanning with hydroxyephedrine: an approach to the localization of pheochromocytoma. J Nucl Med 1992; 33:1125- 1131.
    Medline Google Scholar
  • 17 Martin WRW, Palmer MR, Patlak CS, Calne DB. Nigrostriatal function in humans studied with positron emission tomography. Ann Neurol 1989; 26:535- 542.
    Medline Google Scholar
  • 18 Huang SC, Yu DC, Bario JR, et al. Kinetics and modeling of L-6-[18F]fluoro-DOPA in human positron emission tomographic studies. J Cereb Blood Flow Metab 1991; 11:898-913.
    Medline Google Scholar
  • 19 Hoegerle S, Schneider B, Kraft A, Moser E, Nitzsche EU. Imaging of a metastatic gastrointestinal carcinoid by F-18-DOPA positron emission tomography. Nuklearmedizin 1999; 38:127-130.
    Medline Google Scholar
  • 20 Hoegerle S, Altehoefer C, Ghanem N, et al. Whole-body 18F dopa PET for detection of gastrointestinal carcinoid tumors. Radiology 2001; 220:373-380.
    Google Scholar
  • 21 Hoegerle S, Altehoefer C, Ghanem N, Brink I, Moser E, Nitzsche E. 18F DOPA positron emission tomography for tumour detection in patients with medullary thyroid carcinoma and elevated calcitonin levels. Eur J Nucl Med 2001; 28:64-71.
    Medline Google Scholar

Article History

Published in print: Feb 2002