Skip to main content

Advertisement

SpringerLink
Log in

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

  • Short Communication
  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  1. 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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. 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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. 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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. 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.

    Article  CAS  Google Scholar 

  5. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  6. 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.

    Article  PubMed  Google Scholar 

  7. 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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  9. 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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

The review did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.

Author information

Authors and Affiliations

  1. Department of Endocrinology, Conception University Hospital, Aix-Marseille University, Marseille, France

    Vincent Amodru, Thierry Brue & Frédéric Castinetti

  2. Department of Endocrine Surgery, Conception University Hospital, Aix-Marseille University, Marseille, France

    Carole Guerin & Frédéric Sebag

  3. Department of Nuclear Medicine, La Timone University Hospital, European Center for Research in Medical Imaging, Aix-Marseille University, 264, rue Saint-Pierre, 13385, Marseille, France

    Sarkis Delcourt & David Taïeb

  4. Laboratory of Molecular Biology, Conception Hospital & CNRS, CRN2M UMR 7286, Aix-Marseille University, Marseille, France

    Pauline Romanet

  5. Department of Public Health, EA3279 Self-perceived Health Assessment Research Unit, La Timone University, Aix-Marseille University, Marseille, France

    Anderson Loundou

  6. Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health & Human Development, National Institutes of Health, Bethesda, MD, USA

    Bruna Viana & Karel Pacak

Authors
  1. Vincent Amodru
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Carole Guerin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sarkis Delcourt
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Pauline Romanet
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anderson Loundou
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Bruna Viana
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Thierry Brue
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Frédéric Castinetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Frédéric Sebag
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Karel Pacak
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. David Taïeb
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David Taïeb.

Ethics declarations

Disclosure of potential conflicts of interest

The authors have nothing to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Amodru, V., Guerin, C., Delcourt, S. et al. Quantitative 18F-DOPA PET/CT in pheochromocytoma: the relationship between tumor secretion and its biochemical phenotype. Eur J Nucl Med Mol Imaging 45, 278–282 (2018). https://doi.org/10.1007/s00259-017-3833-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-017-3833-y

Keywords

Search

Navigation