Combining 6-fluoro-[18F]l-dihydroxyphenylalanine and [18F]fluoro-2-deoxy-d-glucose positron emission tomography for distinction of non-carcinoid malignancies in carcinoid patients.
OBJECTIVE
Carcinoid patients frequently develop a second primary malignancy (SPM), which can deserve full treatment. Distinguishing a SPM from carcinoid lesions is therefore important. Differentiation can be achieved using the difference in uptake between different positron emission tomography (PET) tracers.


RESULTS
Between January 2005 and August 2008, 105 carcinoid patients were seen at the Department of Medical Oncology for treatment and follow-up. We identified 3 patients who presented with a new SPM in whom differentiation between carcinoid lesions and the SPM was guided by functional imaging of the catecholamine pathway with 6-fluoro-[(18)F]l-dihydroxyphenylalanine ((18)F-DOPA) PET and [(18)F]fluoro-2-deoxy-d-glucose ((18)F-FDG) PET as radiotracer for the glucose metabolism. All 3 patients had metastatic carcinoid disease and localised adenocarcinoma based on the PET-scans. For the adenocarcinoma they received curative treatment.


CONCLUSIONS
The difference in uptake between these PET techniques can be used for decision making when a primary or metastatic SPM is suspected.
Fiebrich
Helle-Brit
HB
Department of Medical Oncology, University Medical Center Groningen, 9700 RB Groningen, The Netherlands.
Brouwers
Adrienne H
AH
Koopmans
Klaas Pieter
KP
de Vries
Elisabeth G E
EG
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000556:secondary; D000368:Aged; D002276:Carcinoid Tumor / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; C043437:fluorodopa F 18; D004295:Dihydroxyphenylalanine