Top

European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-02-2018 | Short Communication

Quantitative ¹⁸F-DOPA PET/CT in pheochromocytoma: the relationship between tumor secretion and its biochemical phenotype

Authors: Vincent Amodru, Carole Guerin, Sarkis Delcourt, Pauline Romanet, Anderson Loundou, Bruna Viana, Thierry Brue, Frédéric Castinetti, Frédéric Sebag, Karel Pacak, David Taïeb

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 2/2018

Abstract

Introduction

¹⁸F-FDOPA illustrates the properties of uptake and storage of catecholamines in pheochromocytomas (PHEOs). Until now, the relationship between ¹⁸F-FDOPA quantitative parameters and a PHEO secretory profile has not been specifically evaluated.

Materials and methods

Fifty-six patients (56% females, median age: 47.5 yrs) with non-metastatic PHEO, evaluated by ¹⁸F-FDOPA PET/CT, were included in this retrospective study. Forty-five patients had negative genetic testing (80.4%); five patients (8.9%) had RET, two patients (3.6%) had SDHB, two had SDHD (3.6%), one patient (1.8%) had NF1, and one patient had a VHL (1.8%) mutation. Correlation between ¹⁸F-FDOPA metabolic parameters (tumor SUVmax, tumor SUVmean, tumor SUVmax/liver SUVmax, MTV 42%, total lesion uptake), urinary metanephrines (MNs), and plasma chromogranin A (CgA) were evaluated.

Results

All patients had positive ¹⁸F-FDOPA PET/CT. On univariate analysis, there was a strong correlation between all metabolic parameters and urinary MNs and plasma chromogranin A (CgA). The highest correlations were observed between total lesion (TL) uptake and the value of urinary MNs regardless of their nature (p = 8.10⁻¹⁵ and r = 0.80) and between MTV 42% and plasma CgA levels (p = 2.10⁻⁹, r = 0.74). On multivariate analysis, the correlation of uptake parameters and CgA levels did not persist further due to the relation of CgA and tumor diameter. A correlation between TL uptake and the normetanephrine/metanephrine ratio (NMN/MN) was also found, a finding that was in accordance with in vitro studies, which were found to have a higher catecholamine content in epinephrine producing PHEOs.

Conclusion

This retrospective study shows a correlation between ¹⁸F-FDOPA uptake, especially using TL uptake, urinary MNs, and a PHEO biochemical phenotype. This illustrates that beyond its localization value, ¹⁸F-FDOPA PET further enables PHEO characterization at a specific metabolic level.

Eisenhofer G, Lenders JW, Timmers H, Mannelli M, Grebe SK, Hofbauer LC, et al. Measurements of plasma methoxytyramine, normetanephrine, and metanephrine as discriminators of different hereditary forms of pheochromocytoma. Clin Chem. 2011;57:411–20.CrossRefPubMedPubMedCentral

Eisenhofer G, Siegert G, Kotzerke J, Bornstein SR, Pacak K. Current progress and future challenges in the biochemical diagnosis and treatment of pheochromocytomas and paragangliomas. Horm Metab Res. 2008;40:329–37. https://doi.org/10.1055/s-2008-1073156.CrossRefPubMedPubMedCentral

Timmers HJ, Chen CC, Carrasquillo JA, Whatley M, Ling A, Havekes B, et al. Comparison of 18F-Fluoro-L-DOPA, 18F-Fluoro-Deoxyglucose, and 18F-Fluorodopamine PET and 123I-MIBG Scintigraphy in the localization of Pheochromocytoma and Paraganglioma. J Clin Endocrinol Metab. 2009;94:4757–67.CrossRefPubMedPubMedCentral

Havekes B, King K, Lai EW, Romijn JA, Corssmit EP, Pacak K. New imaging approaches to phaeochromocytomas and paragangliomas. Clin Endocrinol. 2010;72:137–45.CrossRef

Barollo S, Bertazza L, Watutantrige-Fernando S, Censi S, Cavedon E, Galuppini F, et al. Overexpression of L-type amino acid transporter 1 (LAT1) and 2 (LAT2): novel markers of Neuroendocrine Tumors. PLoS One. 2016;11:e0156044. https://doi.org/10.1371/journal.pone.0156044.CrossRefPubMedPubMedCentral

Treglia G, Cocciolillo F, de Waure C, Di Nardo F, Gualano MR, Castaldi P, et al. Diagnostic performance of 18F-dihydroxyphenylalanine positron emission tomography in patients with paraganglioma: a meta-analysis. Eur J Nucl Med Mol Imaging. 2012;39:1144–53. https://doi.org/10.1007/s00259-012-2087-y.CrossRefPubMed

Fiebrich HB, de Jong JR, Kema IP, Koopmans KP, Sluiter W, Dierckx RA, et al. Total 18F-dopa PET tumour uptake reflects metabolic endocrine tumour activity in patients with a carcinoid tumour. Eur J Nucl Med Mol Imaging. 2011;38:1854–61. https://doi.org/10.1007/s00259-011-1862-5.CrossRefPubMedPubMedCentral

Krause W, Michael N, Lubke C, Livett BG, Oehme P. Catecholamine release from fractionated chromaffin cells. Eur J Pharmacol. 1996;302:223–8.CrossRefPubMed

Eisenhofer G, Huynh TT, Elkahloun A, Morris JC, Bratslavsky G, Linehan WM, et al. Differential expression of the regulated catecholamine secretory pathway in different hereditary forms of pheochromocytoma. Am J Physiol Endocrinol Metab. 2008;295:E1223–33. https://doi.org/10.1152/ajpendo.90591.2008.CrossRefPubMedPubMedCentral

10.

Eisenhofer G, Pacak K, Huynh TT, Qin N, Bratslavsky G, Linehan WM, et al. Catecholamine metabolomic and secretory phenotypes in phaeochromocytoma. Endocr Relat Cancer. 2011;18:97–111.CrossRefPubMed

Title: Quantitative 18F-DOPA PET/CT in pheochromocytoma: the relationship between tumor secretion and its biochemical phenotype
Authors: Vincent Amodru
Carole Guerin
Sarkis Delcourt
Pauline Romanet
Anderson Loundou
Bruna Viana
Thierry Brue
Frédéric Castinetti
Frédéric Sebag
Karel Pacak
David Taïeb
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 2/2018
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-017-3833-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Quantitative ¹⁸F-DOPA PET/CT in pheochromocytoma: the relationship between tumor secretion and its biochemical phenotype

Abstract

Introduction

Materials and methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2018

Patterns of bone tracer uptake on SPECT-CT in symptomatic and asymptomatic patients with primary total hip arthroplasty

A score combining baseline neutrophilia and primary tumor SUVpeak measured from FDG PET is associated with outcome in locally advanced cervical cancer

68Ga-PSMA-11 PET/CT in primary staging of prostate carcinoma: preliminary results on differences between black and white South-Africans

Invited editorial for the paper by Silvoniemi et al. “Repeatability of tumor hypoxia imaging using [18F]EF5 PET/CT in head and neck cancer.” in this issue of EJNMMI

Correction to: Peptide receptor radionuclide therapy (PRRT) in European Neuroendocrine Tumour Society (ENETS) grade 3 (G3) neuroendocrine neoplasia (NEN) - a single-institution retrospective analysis

Prediction of disease-free survival by the PET/CT radiomic signature in non-small cell lung cancer patients undergoing surgery