Annika M A Berends1, Michiel N Kerstens1, Janne W Bolt1, Thera P Links1, Esther Korpershoek2, Ronald R de Krijger2, Annemiek M E Walenkamp3, Walter Noordzij4, Boudewijn van Etten5, Gursah Kats-Ugurlu6, Adrienne H Brouwers4, Anouk N A van der Horst-Schrivers1. 1. Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 2. Department of Pathology, Erasmus University Medical Center, Rotterdam and Reinier de Graaf Hospital, Delft, The Netherlands. 3. Departments of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 4. Departments of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 5. Departments of Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 6. Departments of Pathology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Abstract
BACKGROUND/AIM: PET with 6-[18F]fluor-l-3,4-dihydroxyphenylalanine (18F-FDOPA) has been shown to be a useful imaging tool with a high sensitivity for the visualization of neuroendocrine tumors (NETs). 18F-FDOPA uptake in tumors other than NETs has been suggested previously, but data on this phenomenon are limited. We therefore studied the non-physiological, false-positive uptake of 18F-FDOPA in a large population of patients with a NET or with a high clinical suspicion of harboring a NET. PATIENTS AND METHODS: Retrospective single-center study among adult patients in whom 18F-FDOPA PET scintigraphy was performed between January 2004 and December 2014. The original scan report was compared with the original pathology report corresponding with 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. Specimens of these non-NET tissues were immunohistochemically stained for AADC. 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 in 508 (72%) cases. In seven cases, the histopathology was not compatible with NET but showed squamous cell carcinoma of the cervix, multiple myeloma (two cases), hepatocellular carcinoma, Schwannoma, adrenocortical carcinoma and a skeletal myxoid chondrosarcoma, with positive immunohistochemical staining for AADC in 67%. CONCLUSIONS: Pathological uptake of 18F-FDOPA does not always indicate the presence of a NET. The possibility of 18F-FDOPA uptake by tumor types other than NETs, although rare, should be considered.
BACKGROUND/AIM: PET with 6-[18F]fluor-l-3,4-dihydroxyphenylalanine (18F-FDOPA) has been shown to be a useful imaging tool with a high sensitivity for the visualization of neuroendocrine tumors (NETs). 18F-FDOPA uptake in tumors other than NETs has been suggested previously, but data on this phenomenon are limited. We therefore studied the non-physiological, false-positive uptake of 18F-FDOPA in a large population of patients with a NET or with a high clinical suspicion of harboring a NET. PATIENTS AND METHODS: Retrospective single-center study among adult patients in whom 18F-FDOPA PET scintigraphy was performed between January 2004 and December 2014. The original scan report was compared with the original pathology report corresponding with 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. Specimens of these non-NET tissues were immunohistochemically stained for AADC. 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 in 508 (72%) cases. In seven cases, the histopathology was not compatible with NET but showed squamous cell carcinoma of the cervix, multiple myeloma (two cases), hepatocellular carcinoma, Schwannoma, adrenocortical carcinoma and a skeletal myxoid chondrosarcoma, with positive immunohistochemical staining for AADC in 67%. CONCLUSIONS: Pathological uptake of 18F-FDOPA does not always indicate the presence of a NET. The possibility of 18F-FDOPA uptake by tumor types other than NETs, although rare, should be considered.
Authors: David Taïeb; Rodney J Hicks; Elif Hindié; Benjamin A Guillet; Anca Avram; Pietro Ghedini; Henri J Timmers; Aaron T Scott; Saeed Elojeimy; Domenico Rubello; Irène J Virgolini; Stefano Fanti; Sona Balogova; Neeta Pandit-Taskar; Karel Pacak Journal: Eur J Nucl Med Mol Imaging Date: 2019-06-29 Impact factor: 9.236
Authors: Annika M A Berends; Graeme Eisenhofer; Lauren Fishbein; Anouk N A V D Horst-Schrivers; Ido P Kema; Thera P Links; Jacques W M Lenders; Michiel N Kerstens Journal: Cancers (Basel) Date: 2019-08-06 Impact factor: 6.639