6-L-18F-Fluorodihydroxyphenylalanine PET in Neuroendocrine Tumors: Basic Aspects and Emerging Clinical Applications

• Published in: The Journal of nuclear medicine (1978) Vol. 49; no. 4; pp. 573 - 586
• Main Authors: Jager, Pieter L, Chirakal, Raman, Marriott, Christopher J, Brouwers, Adrienne H, Koopmans, Klaas Pieter, Gulenchyn, Karen Y
• Format: Journal Article
• Language: English
• Published: United States Soc Nuclear Med 01.04.2008
• Subjects: Adenoma, Islet Cell - diagnostic imaging; Dihydroxyphenylalanine - analogs & derivatives; Humans; Hyperinsulinism - diagnostic imaging; Neuroendocrine Tumors - diagnostic imaging; Pancreatic Neoplasms - diagnostic imaging; Pheochromocytoma - diagnostic imaging; Positron-Emission Tomography; Thyroid Neoplasms - diagnostic imaging
• ISSN: 0161-5505; 1535-5667
• DOI: 10.2967/jnumed.107.045708

In recent years, 6-l-18F-fluorodihydroxyphenylalanine (18F-DOPA) PET has emerged as a new diagnostic tool for the imaging of neuroendocrine tumors. This application is based on the unique property of neuroendocrine tumors to produce and secrete various substances, a process that requires the uptake of metabolic precursors, which leads to the uptake of 18F-DOPA. This nonsystematic review first describes basic aspects of 18F-DOPA imaging, including radiosynthesis, factors involved in tracer uptake, and various aspects of metabolism and imaging. Subsequently, this review provides an overview of current clinical applications in neuroendocrine tumors, including carcinoid tumors, pancreatic islet cell tumors, pheochromocytoma, paraganglioma, medullary thyroid cancer, hyperinsulinism, and various other clinical entities. The application of PET/CT in carcinoid tumors has unsurpassed sensitivity. In medullary thyroid cancer, pheochromocytoma, and hyperinsulinism, results are also excellent and contribute significantly to clinical management. In the remaining conditions, the initial experience with 18F-DOPA PET indicates that it seems to be less valuable, but further study is required.