ECE2017 Eposter Presentations: Adrenal and Neuroendocrine Tumours Endocrine tumours and neoplasia (50 abstracts)
False positive findings on 6-[18F]fluor-L-3,4-dihydroxyphenylalanine Positron Emission Tomography (18F-FDOPA-PET) performed for imaging of neuroendocrine tumors
MA Berends 1 , JW Bolt 1 , MN Kerstens 1 , TP Links 1 , E Korpershoek 2 , RR de Krijger 2, , AME Walenkamp 1 , W Noordzij 1 , B van Etten 1 , G Kats-Urgurlu 1 , AH Brouwers 1 & ANA van der Horst-Schrivers 1
1University Medical Center Groningen, Groningen, The Netherlands; 2Erasmus University Medical Center, Rotterdam, The Netherlands; 3Reinier de Graaf Hospital, Delft, The Netherlands.
Background/Aim: Neuroendocrine tumors (NETs) are rare tumors arising from neuroendocrine cells throughout the body. Positron Emission Tomography (PET) scanning with 6-[18F]fluor-L-3,4-dihydroxyphenylalanine (18F-FDOPA) has been shown to be a valuable technique for the imaging of NETs. While the sensitivity has been assessed numerously, studies systematically describing false positive results, other than physiological variants, are lacking. Our aim was to systematically examine, in a large series of 18F-FDOPA PET scans, false-positive results and determine which other tumor types have the potential of 18F-FDOPA uptake.
Patients and methods: A single-center study was conducted among patients, aged 18 years or older, who underwent a 18F-FDOPA-PET scan for the clinical suspicion or follow-up of a NET between January 2004 and December 2014. Clinical data were retrieved from medical charts. We compared the original 18F-FDOPA PET scan report with the pathology report of the 18F-FDOPA PET-positive lesion. In case this was inconsistent with the diagnosis of a NET, both the scan and the pathology slides were reassessed. Non- NET tissues were immunohistochemically stained for aromatic-L-aminoacid decarboxylase (AADC), Chromogranin A and Synaptophysin.
Results: 1070 18F-FDOPA PET scans from 705 patients were evaluated. Focal or multiple 18F-FDOPA avid lesions were described in 709 18F-FDOPA PET scans (66%). Histology of these 18F-FDOPA PET positive lesions was present for 508 (72%) scans. In eight cases the original pathology report and revision was not compatible with a NET but showed a squamous cell carcinoma of the cervix and larynx, a multiple myeloma (in two cases), a hepatocellular carcinoma, a schwannoma, an adrenocortical carcinoma and a skeletal myxoid chondrosarcoma, with positive immunohistochemical staining for AADC in four out of the seven stained tumor tissues.
Conclusions: Pathological uptake of 18F-FDOPA does not always indicate the presence of a NET. The possibilty of 18F-FDOPA uptake by tumor types other than NETs should be considered.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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