Myocardial metastases on 6-[18F] fluoro-L-DOPA PET/CT: a retrospective analysis of 116 serotonin producing neuroendocrine tumour patients.
OBJECTIVE
This study evaluates the prevalence of cardiac metastases in patients with serotonin producing neuroendocrine tumours (NET), examined with 18F-FDOPA PET/CT, and the relationship of these metastases to the presence of carcinoid heart disease (CHD) based on echocardiography.


BACKGROUND
CHD occurs in patients with serotonin producing NET. The diagnostic method of choice remains echocardiography. The precise prevalence of cardiac metastases is unknown given the limitations of standard technologies. Nuclear medicine modalities have the potential to visualize metastases of NET.


METHODS
All patients who underwent 18F-FDOPA PET/CT because of serotonin producing NET between November 2009 and May 2012 were retrospectively analyzed. The presence of cardiac metastasis was defined as myocardial tracer accumulation higher than the surrounding physiological myocardial uptake. Laboratory tests and transthoracic echocardiography (TTE) results were digitally collected.


RESULTS
116 patients (62 male) underwent 18F-FDOPA PET/CT, mean age was 61±13 years. TTE was performed in 79 patients. Cardiac metastases were present in 15 patients, of which 10 patients also underwent TTE. One patient had both cardiac metastasis (only on 18F-FDOPA PET/CT) and echocardiographic signs of CHD. There were no differences in echocardiographic parameters for CHD between patients with and without cardiac metastases. TTE in none of the 79 patients showed cardiac metastases.


CONCLUSIONS
The prevalence of cardiac metastases detected with 18F-FDOPA PET/CT in this study is 13%. 18F-FDOPA PET/CT can visualize cardiac metastases in serotonin producing NET patients. There appears to be no relationship between the presence of cardiac metastases and TTE parameters of CHD.
Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Walter
W
Noordzij
Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
André P
AP
van Beek
Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
René A
RA
Tio
Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Anouk N
AN
van der Horst-Schrivers
Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Elisabeth G
EG
de Vries
Faculty of Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Bram
B
van Ginkel
Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Annemiek M
AM
Walenkamp
Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Andor W
AW
Glaudemans
Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Riemer H
RH
Slart
Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Rudi A
RA
Dierckx
D002275:Carcinoid Heart Disease / Q000150:complications / Q000000981:diagnostic imaging; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives*; D005260:Female; D006338:Heart Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009206:Myocardium / Q000473:pathology*; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging / Q000473:pathology; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D012701:Serotonin / Q000096:biosynthesis*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
C043437:fluorodopa F 18; D012701:Serotonin; D004295:Dihydroxyphenylalanine