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PET/CT using 18F-FDOPA provides improved staging of carcinoid tumor patients in a Canadian setting.
MedLine Citation:
PMID:  22183015     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIM: In Canada, staging of carcinoid tumors is largely based on computed tomography (CT) imaging sometimes complemented with somatostatin receptor scintigraphy (SRS). This study assessed the diagnostic accuracy of 6-[F]fluoro-3,4-dihydroxyphenylalanine (F-FDOPA) PET/CT in neuroendocrine tumors. METHODS: We prospectively included 27 patients with either suspected carcinoid (n=6, with all prior tests negative) or with an established diagnosis of intestinal carcinoid tumor (n=21) from two Canadian treatment centers. Findings of F-FDOPA PET/CT were compared with SRS, CT, and combined SRS/CT using a composite reference standard comprising all available imaging, biochemistry, surgery, and follow-up data. Sensitivity was calculated per patient, per body region, and per lesion. The contribution to patient management was estimated from the feedback of attending physicians. RESULTS: In documented carcinoid patients, F-FDOPA PET/CT identified disease in 20 of 21 patients (patient-based sensitivity 95%). In 56 positive regions, F-FDOPA PET/CT detected 53, CT detected 34, SRS detected 34, and CT+SRS detected 39 regions, leading to region-based sensitivities of 95, 61, 62, and 71%, respectively. Lesion-based sensitivities were 96, 69, 50, and 72%, respectively. In the six patients with suspected disease only, one CT scan was positive, but F-FDOPA PET/CT was negative for all. F-FDOPA PET contributed to patient management in 12/21 patients (57%). CONCLUSION: F-FDOPA PET/CT proved to be an excellent modality for staging of carcinoid tumor patients, with superior performance compared with currently applied methods in Canada. In patients with suspected disease with negative prior imaging investigations, F-FDOPA was not helpful.
Authors:
Valerie N Yakemchuk; Pieter L Jager; Raman Chirakal; Robert Reid; Pierre Major; Karen Y Gulenchyn
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-16
Journal Detail:
Title:  Nuclear medicine communications     Volume:  -     ISSN:  1473-5628     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8201017     Medline TA:  Nucl Med Commun     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
aDepartment of Nuclear Medicine, Hamilton Health Sciences bMcMaster University cJuravinski Cancer Center, Hamilton dLondon Health Sciences Center, London, Ontario, Canada.
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