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

  • Vincent Amodru
  • Carole Guerin
  • Sarkis Delcourt
  • Pauline Romanet
  • Anderson Loundou
  • Bruna Viana
  • Thierry Brue
  • Frédéric Castinetti
  • Frédéric Sebag
  • Karel Pacak
  • David Taïeb
Short Communication

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.

Keywords

Pheochromocytomas · 18F-FDOPA · Radionuclide imaging · Genetics 

Notes

Funding

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

Compliance with ethical standards

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.

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Vincent Amodru
    • 1
  • Carole Guerin
    • 2
  • Sarkis Delcourt
    • 3
  • Pauline Romanet
    • 4
  • Anderson Loundou
    • 5
  • Bruna Viana
    • 6
  • Thierry Brue
    • 1
  • Frédéric Castinetti
    • 1
  • Frédéric Sebag
    • 2
  • Karel Pacak
    • 6
  • David Taïeb
    • 3
  1. 1.Department of Endocrinology, Conception University HospitalAix-Marseille UniversityMarseilleFrance
  2. 2.Department of Endocrine Surgery, Conception University HospitalAix-Marseille UniversityMarseilleFrance
  3. 3.Department of Nuclear Medicine, La Timone University Hospital, European Center for Research in Medical ImagingAix-Marseille UniversityMarseilleFrance
  4. 4.Laboratory of Molecular Biology, Conception Hospital & CNRS, CRN2M UMR 7286Aix-Marseille UniversityMarseilleFrance
  5. 5.Department of Public Health, EA3279 Self-perceived Health Assessment Research Unit, La Timone UniversityAix-Marseille UniversityMarseilleFrance
  6. 6.Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health & Human DevelopmentNational Institutes of HealthBethesdaUSA

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