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The effects of molar activity on [(18)F]FDOPA uptake in patients with neuroendocrine tumors

BACKGROUND: 6-[(18)F]fluoro-l-3,4-dihydroxyphenyl alanine ([(18)F]FDOPA) is a commonly used PET tracer for the detection and staging of neuroendocrine tumors. In neuroendocrine tumors, [(18)F]FDOPA is decarboxylated to [(18)F]dopamine via the enzyme amino acid decarboxylase (AADC), leading to increa...

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Autores principales: Stormezand, Gilles N., Schreuder, Romano S. B. H., Brouwers, Adrienne H., Slart, Riemer H. J. A., Elsinga, Philip H., Walenkamp, Annemiek M. E., Dierckx, R. A. J. O., Glaudemans, Andor W. J. M., Luurtsema, Gert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8426426/
https://www.ncbi.nlm.nih.gov/pubmed/34495420
http://dx.doi.org/10.1186/s13550-021-00829-z
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author Stormezand, Gilles N.
Schreuder, Romano S. B. H.
Brouwers, Adrienne H.
Slart, Riemer H. J. A.
Elsinga, Philip H.
Walenkamp, Annemiek M. E.
Dierckx, R. A. J. O.
Glaudemans, Andor W. J. M.
Luurtsema, Gert
author_facet Stormezand, Gilles N.
Schreuder, Romano S. B. H.
Brouwers, Adrienne H.
Slart, Riemer H. J. A.
Elsinga, Philip H.
Walenkamp, Annemiek M. E.
Dierckx, R. A. J. O.
Glaudemans, Andor W. J. M.
Luurtsema, Gert
author_sort Stormezand, Gilles N.
collection PubMed
description BACKGROUND: 6-[(18)F]fluoro-l-3,4-dihydroxyphenyl alanine ([(18)F]FDOPA) is a commonly used PET tracer for the detection and staging of neuroendocrine tumors. In neuroendocrine tumors, [(18)F]FDOPA is decarboxylated to [(18)F]dopamine via the enzyme amino acid decarboxylase (AADC), leading to increased uptake when there is increased AADC activity. Recently, in our hospital, a new GMP compliant multi-dose production of [(18)F]FDOPA has been developed, [(18)F]FDOPA-H, resulting in a higher activity yield, improved molar activity and a lower administered mass than the conventional method ([(18)F]FDOPA-L). AIMS: This study aimed to investigate whether the difference in molar activity affects the [(18)F]FDOPA uptake at physiological sites and in tumor lesions, in patients with NET. It was anticipated that the specific uptake of [(18)F]FDOPA-H would be equal to or higher than [(18)F]FDOPA-L. METHODS: We retrospectively analyzed 49 patients with pathologically confirmed NETs and stable disease who underwent PET scanning using both [(18)F]FDOPA-H and [(18)F]FDOPA-L within a time span of 5 years. A total of 98 [(18)F]FDOPA scans (49 [(18)F]FDOPA-L and 49 [(18)F]FDOPA-H with average molar activities of 8 and 107 GBq/mmol) were analyzed. The SUVmean was calculated for physiological organ uptake and SUVmax for tumor lesions in both groups for comparison, and separately in subjects with low tumor load (1–2 lesions) and higher tumor load (3–10 lesions). RESULTS: Comparable or slightly higher uptake was demonstrated in various physiological uptake sites in subjects scanned with [(18)F]FDOPA-H compared to [(18)F]FDOPA-L, with large overlap being present in the interquartile ranges. Tumor uptake was slightly higher in the [(18)F]FDOPA-H group with 3–10 lesion (SUVmax 6.83 vs. 5.19, p < 0.001). In the other groups, no significant differences were seen between H and L. CONCLUSION: [18F]FDOPA-H provides a higher activity yield, offering the possibility to scan more patients with one single production. Minor differences were observed in SUV’s, with slight increases in uptake of [(18)F]FDOPA-H in comparison to [(18)F]FDOPA-L. This finding is not a concern for clinical practice, but could be of importance when quantifying follow-up scans while introducing new production methods with a higher molar activity of [(18)F]FDOPA.
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spelling pubmed-84264262021-09-29 The effects of molar activity on [(18)F]FDOPA uptake in patients with neuroendocrine tumors Stormezand, Gilles N. Schreuder, Romano S. B. H. Brouwers, Adrienne H. Slart, Riemer H. J. A. Elsinga, Philip H. Walenkamp, Annemiek M. E. Dierckx, R. A. J. O. Glaudemans, Andor W. J. M. Luurtsema, Gert EJNMMI Res Original Research BACKGROUND: 6-[(18)F]fluoro-l-3,4-dihydroxyphenyl alanine ([(18)F]FDOPA) is a commonly used PET tracer for the detection and staging of neuroendocrine tumors. In neuroendocrine tumors, [(18)F]FDOPA is decarboxylated to [(18)F]dopamine via the enzyme amino acid decarboxylase (AADC), leading to increased uptake when there is increased AADC activity. Recently, in our hospital, a new GMP compliant multi-dose production of [(18)F]FDOPA has been developed, [(18)F]FDOPA-H, resulting in a higher activity yield, improved molar activity and a lower administered mass than the conventional method ([(18)F]FDOPA-L). AIMS: This study aimed to investigate whether the difference in molar activity affects the [(18)F]FDOPA uptake at physiological sites and in tumor lesions, in patients with NET. It was anticipated that the specific uptake of [(18)F]FDOPA-H would be equal to or higher than [(18)F]FDOPA-L. METHODS: We retrospectively analyzed 49 patients with pathologically confirmed NETs and stable disease who underwent PET scanning using both [(18)F]FDOPA-H and [(18)F]FDOPA-L within a time span of 5 years. A total of 98 [(18)F]FDOPA scans (49 [(18)F]FDOPA-L and 49 [(18)F]FDOPA-H with average molar activities of 8 and 107 GBq/mmol) were analyzed. The SUVmean was calculated for physiological organ uptake and SUVmax for tumor lesions in both groups for comparison, and separately in subjects with low tumor load (1–2 lesions) and higher tumor load (3–10 lesions). RESULTS: Comparable or slightly higher uptake was demonstrated in various physiological uptake sites in subjects scanned with [(18)F]FDOPA-H compared to [(18)F]FDOPA-L, with large overlap being present in the interquartile ranges. Tumor uptake was slightly higher in the [(18)F]FDOPA-H group with 3–10 lesion (SUVmax 6.83 vs. 5.19, p < 0.001). In the other groups, no significant differences were seen between H and L. CONCLUSION: [18F]FDOPA-H provides a higher activity yield, offering the possibility to scan more patients with one single production. Minor differences were observed in SUV’s, with slight increases in uptake of [(18)F]FDOPA-H in comparison to [(18)F]FDOPA-L. This finding is not a concern for clinical practice, but could be of importance when quantifying follow-up scans while introducing new production methods with a higher molar activity of [(18)F]FDOPA. Springer Berlin Heidelberg 2021-09-08 /pmc/articles/PMC8426426/ /pubmed/34495420 http://dx.doi.org/10.1186/s13550-021-00829-z Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Research
Stormezand, Gilles N.
Schreuder, Romano S. B. H.
Brouwers, Adrienne H.
Slart, Riemer H. J. A.
Elsinga, Philip H.
Walenkamp, Annemiek M. E.
Dierckx, R. A. J. O.
Glaudemans, Andor W. J. M.
Luurtsema, Gert
The effects of molar activity on [(18)F]FDOPA uptake in patients with neuroendocrine tumors
title The effects of molar activity on [(18)F]FDOPA uptake in patients with neuroendocrine tumors
title_full The effects of molar activity on [(18)F]FDOPA uptake in patients with neuroendocrine tumors
title_fullStr The effects of molar activity on [(18)F]FDOPA uptake in patients with neuroendocrine tumors
title_full_unstemmed The effects of molar activity on [(18)F]FDOPA uptake in patients with neuroendocrine tumors
title_short The effects of molar activity on [(18)F]FDOPA uptake in patients with neuroendocrine tumors
title_sort effects of molar activity on [(18)f]fdopa uptake in patients with neuroendocrine tumors
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8426426/
https://www.ncbi.nlm.nih.gov/pubmed/34495420
http://dx.doi.org/10.1186/s13550-021-00829-z
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