Comparison of 6-18F-Fluoro-l-DOPA, 18F-2-deoxy-d- glucose, CT, and MRI in patients with pancreatic neuroendocrine neoplasms with von Hippel-Lindau disease

Mio Kitano, Corina Millo, Reza Rahbari, Peter Herscovitch, Krisana Gesuwan, Richard C. Webb, Aradhana M. Venkatesan, Giao Q. Phan, Marybeth S. Hughes, Steven K. Libutti, Naris Nilubol, William M. Linehan, Electron Kebebew

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Abstract

Introduction: There are limited data on the utility of 6- 18F-fluoro-l-3,4-dihydroxyphenylalanine (18F-DOPA) and 18F-2-deoxy-d-glucose (18F-FDG) in the workup of patients with pancreatic neuroendocrine tumors (PNETs). The aim of our study was to determine the accuracy of 18F-DOPA and 18F-FDG to detect PNETs in patients with von Hippel-Lindau disease (vHL). Methods: We studied prospectively 69 patients with a diagnosis of vHL and pancreatic lesion(s) using computed tomography (CT), magnetic resonance imaging (MRI), 18F-FDG, and 18F-DOPA. Clinical, genetic, and laboratory characteristics were analyzed to determine association with imaging study results. Results: In sum, 40 patients underwent evaluation by all 4 modalities; 98 PNETs and 55 PNETs were identified on CT and MRI, respectively. Only 11 of the 98 lesions (11%) were positive on 18F-DOPA and 45 of the 98 (46%) lesions were positive on 18F-FDG. There were 13 18F-DOPA and 26 18F-FDG avid extrapancreatic lesions. One patient underwent resection of an 18F-DOPA avid extrapancreatic lesion in the lung, with pathology demonstrating a NET. There was no association between 18F-DOPA and 18F-FDG avidity and tumor size, age, gender, vHL mutation, or serum chromogranin A level. Conclusion: 18F-FDG and MRI may be adjuncts to CT in identifying PNETs and metastatic disease. 18F-DOPA has limited value in identifying PNETs in patients with vHL, but may be useful for identifying extrapancreatic NET lesions.

Original languageEnglish (US)
Pages (from-to)1122-1128
Number of pages7
JournalSurgery
Volume150
Issue number6
DOIs
Publication statusPublished - Dec 1 2011

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ASJC Scopus subject areas

  • Surgery

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