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Nuclear Medicine |
1 From the Department of Radiology, Divisions of Nuclear Medicine (S.H., E.M., E.N.) and Diagnostic Radiology (C.A., N.G.), Department of Pathology (G.K.), and Department of Internal Medicine, Division of Hemato-oncology (C.F.W.), Albert-Ludwigs University, Hugstetterstrasse 55, 79106 Freiburg, Germany; and the Department of Gastroenterology, University Hospital Benjamin Franklin, Free University Berlin, Germany (H.S.). Received August 25, 2000; revision requested October 17; revision received December 21; accepted February 12, 2001. Address correspondence to S.H.
PURPOSE: To evaluate fluorine 18 (18F) dopa positron emission tomography (PET) in comparison with established imaging procedures in gastrointestinal carcinoid tumors.
MATERIALS AND METHODS: After evaluation of the normal distribution of 18F dopa, 17 patients with histologically confirmed tumors were examined with 18F dopa PET. Results of 2-[fluorine 18]fluoro-2-deoxy-D-glucose (FDG) PET, somatostatin-receptor scintigraphy, and morphologic imaging (computed tomography and/or magnetic resonance imaging) were available for all patients. Results of the procedures were evaluated by two radiologists and two nuclear medicine specialists, whose consensus based on all available histologic, imaging, and follow-up findings was used as the reference standard.
RESULTS: Ninety-two tumors were diagnosed: eight primary tumors, 47 lymph node metastases, and 37 organ metastases. 18F dopa PET led to 60 true-positive findings (seven primary tumors, 41 lymph node metastases, 12 organ metastases); FDG PET, 27 (two primary tumors, 14 lymph node metastases, 11 organ metastases); somatostatin-receptor scintigraphy, 52 (four primary tumors, 27 lymph node metastases, 21 organ metastases); and morphologic imaging, 67 (two primary tumors, 29 lymph node metastases, 36 organ metastases). This resulted in the following overall sensitivities: 18F dopa PET, 65% (60 of 92); FDG PET, 29% (27 of 92); somatostatin-receptor scintigraphy, 57% (52 of 92); morphologic procedures, 73% (67 of 92). Although the morphologic procedures were most sensitive for organ metastases, 18F dopa PET enabled best localization of primary tumors and lymph node staging.
CONCLUSION: 18F dopa PET is a promising procedure and useful supplement to morphologic methods in diagnostic imaging of gastrointestinal carcinoid tumors.
Index terms: Carcinoid, 70.316 • Fluorine, radioactive • Gastrointestinal tract, CT, 70.12112, 70.12115 • Gastrointestinal tract, MR, 70.121411, 70.121412 • Gastrointestinal tract, neoplasms, 70.316 • Gastrointestinal tract, PET, 70.12163 • Gastrointestinal tract, SPECT, 70.12162
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