title: 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.
abstract: BACKGROUND
  There are limited data on the utility of 6-(18)F-fluoro-l-3,4-dihydroxyphenylalanine ((18)F-DOPA) and (18)F-2-deoxy-d-glucose ((18)F-FDG) in the workup of patients with pancreatic neuroendocrine tumors (PNETs). The aim of our study was to determine the accuracy of (18)F-DOPA and (18)F-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), (18)F-FDG, and (18)F-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 (18)F-DOPA and 45 of the 98 (46%) lesions were positive on (18)F-FDG. There were 13 (18)F-DOPA and 26 (18)F-FDG avid extrapancreatic lesions. One patient underwent resection of an (18)F-DOPA avid extrapancreatic lesion in the lung, with pathology demonstrating a NET. There was no association between (18)F-DOPA and (18)F-FDG avidity and tumor size, age, gender, vHL mutation, or serum chromogranin A level.
  
  
  CONCLUSIONS
  (18)F-FDG and MRI may be adjuncts to CT in identifying PNETs and metastatic disease. (18)F-DOPA has limited value in identifying PNETs in patients with vHL, but may be useful for identifying extrapancreatic NET lesions.
authors.affiliation: Endocrine Oncology Section, Surgery Branch, National Cancer Institute, National Institutes of Health, CRC, 10 Center Drive, Bethesda, MD 20892, USA.
authors.forename: Mio
authors.initials: M
authors.lastname: Kitano
authors.forename: Corina
authors.initials: C
authors.lastname: Millo
authors.forename: Reza
authors.initials: R
authors.lastname: Rahbari
authors.forename: Peter
authors.initials: P
authors.lastname: Herscovitch
authors.forename: Krisana
authors.initials: K
authors.lastname: Gesuwan
authors.forename: Richard C
authors.initials: RC
authors.lastname: Webb
authors.forename: Aradhana M
authors.initials: AM
authors.lastname: Venkatesan
authors.forename: Giao Q
authors.initials: GQ
authors.lastname: Phan
authors.forename: Marybeth S
authors.initials: MS
authors.lastname: Hughes
authors.forename: Steven K
authors.initials: SK
authors.lastname: Libutti
authors.forename: Naris
authors.initials: N
authors.lastname: Nilubol
authors.forename: William M
authors.initials: WM
authors.lastname: Linehan
authors.forename: Electron
authors.initials: E
authors.lastname: Kebebew
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004298:Dopamine / Q000031:analogs & derivatives*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000150:complications / Q000175:diagnosis*; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis*; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed; D055815:Young Adult; D006623:von Hippel-Lindau Disease / Q000150:complications*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; C029253:6-fluorodopamine; D004298:Dopamine