ECE2011 Poster Presentations Endocrine tumours and neoplasia (37 abstracts)
Metabolic endocrine tumor activity is reflected by total 18F-DOPA PET tumor uptake in patients with a carcinoid tumor
H-B Fiebrich , J R de Jong , I P Kema , K P Koopmans , W J Sluiter , R A J O Dierckx , A M E Walenkamp , A H Brouwers , E G E de Vries & T P Links
University Medical Center Groningen, Groningen, The Netherlands.
Introduction: Positron emission tomography (PET) using 6-[F-18]fluoro-L-dihydroxyphenylalanine (18F-DOPA) has an excellent sensitivity to detect carcinoid tumor lesions. 18F-DOPA-tumor uptake and the levels of biochemical tumor markers are mediated by tumor endocrine metabolic activity. Therefore we evaluated whether total 18F-DOPA-tumor uptake on PET, defined as the whole-body metabolic burden (WBMTB) reflects tumor load per patient, as measured with tumor markers.
Methods: Seventy-seven consecutive carcinoid patients who underwent a 18F-DOPA PET scan in two previously published studies were analyzed. For all tumor lesions mean standardized uptake values (SUVs) at 40% of the maximal SUV and tumor volume on 18F-DOPA PET were determined and multiplied to calculate a metabolic burden per lesion. WBMTB was the sum of the metabolic burden of all individual lesions per patient. As tumor markers served 24-h urinary serotonin, urine and plasma 5-hydroxindole acetic acid (5HIAA); catecholamines (nor)epinephrine, dopamine and their metabolites, measured in urine and plasma, and serum chromogranin A.
Results: All but one were evaluable for WBMTB, 74 patients had metastatic disease. 18F-DOPA PET detected 979 lesions. SUVmax on 18F-DOPA PET varied up to 29-fold between individual lesions within the same patients. WBMTB correlated with urinary serotonin (r=0.51) and urinary and plasma 5HIAA (r=0.78 and 0.66). WBMTB also correlated with urinary norepinephrine, epinephrine, dopamine and plasma dopamine, but not with serum chromogranin A.
Conclusion: Tumor load per patient measured with 18F-DOPA PET correlates with tumor markers of the serotonin and catecholamine pathway in urine and plasma in carcinoid patients and reflects metabolic tumor activity. Although not yet investigated in neuroendocrine tumor patients, WBMTB on 18F-DOPA PET might be an interesting measure of treatment response in patients with a carcinoid tumor.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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