Role of FDOPA PET/CT imaging and conventional imaging in the management of patients with endocrine tumor of unknown origin.
Fiche publication
Date publication
mai 2012
Auteurs
Membres identifiés du Cancéropôle Est :
Pr KURTZ Jean-Emmanuel, Pr PESSAUX Patrick
Tous les auteurs :
Rust E, Goichot B, Kurtz JE, Pessaux P, Imperiale A
Lien Pubmed
Résumé
Introduction. Despite the extensive diagnostic work-up performed by conventional morphologic and functional imaging in patients with endocrine metastatic malignancies, the primary tumor remains often unknown. Knowledge of the primary tumor improves patients' management in case of metastatic disease, and allows curative surgical debulking. At present, few studies have focused on the detection of the primary lesion. Aims. - To retrospectively assess the FDOPA PET/CT accuracy in the detection of primary endocrine tumors and to evaluate the incremental value of FDOPA PET/CT over conventional imaging. Patients and methods. Fourteen patients with biopsy-proven or clinically and biologically suspected endocrine tumors underwent FDOPA PET/CT. Results were compared with conventional imaging, and related to a pathologic or follow-up gold standard. Results. FDOPA PET/CT detected the primary tumor in four out of 14 patients. Conventional imaging detected the primary tumor in three out of 14 patients. The association of FDOPA PET/CT and morphologic imaging allowed the identification of five out of 14 primary tumors. On an organ-based analysis, FDOPA PET/CT detected more metastasis than morphologic imaging (respective sensitivities of 92% and 58%). Conclusion. In our study, FDOPA PET/CT seemed more sensitive than conventional imaging for the detection of primary endocrine tumors and metastatic spread assessment. Physiological pancreatic uptake hampers FDOPA PET/CT accuracy for the detection of islet cell primary malignancies. Moreover, some pathologic characteristics of the endocrine phenotype, such as cellular differentiation, may influence FDOPA tumoral uptake. (C) 2012 Elsevier Masson SAS. All rights reserved.
Référence
. 2012 May;36(5):278-90.