¹⁸F-FDOPA: A Multiple-Target Molecule

Abstract

Although 6-18 F-fluoro-L-dopa ( 18 F-FDOPA) has been available to study the striatal dopaminergic system for more than 2 decades, the full potential of the tracer was not realized before the introduction of 18 F-FDOPA PET and PET/CT to image a variety of neuroendocrine tumors (NETs) and pancreatic b-cell hyperplasia. Together with receptor-based imaging, 18 F-FDOPA offers a formerly unforeseen means to assist in the management of NETs and infants with persistent hyperinsulinemic hyperplasia. Institutions with special expertise in surgical, oncologic, and radiologic therapeutic modalities for NETs derive the highest benefit from 18 F-FDOPA PET/CT. 18 F-FDOPA-guided therapy may add to NET control by ensuring maximal cytoreduction.

Characterization of Neuroblastic Tumors Using 18F-FDOPA PET

“…Although 18 F-FDOPA PET has been used for striatal imaging in parkinsonism since the 1980s, its application to tumor imaging, especially in neuroendocrine tumors, is promising (6,7). For example, in head and neck paragangliomas, 18 F-FDOPA PET has been proven more efficacious than 18 F-fluorodopamine PET, 18 F-FDG PET, 123 I-MIBG scintigraphy, or 111 In-pentetreotide scintigraphy (29).…”

“…By targeting the catecholamine biosynthesis pathway, 6-18 F-fluoro-L-dihydroxyphenylalanine ( 18 F-FDOPA) PET has been used in visualizing neuroendocrine tumors, such as pheochromocytoma, paraganglioma, gastroenteropancreatic neuroendocrine tumors, and medullary thyroid carcinoma (6,7). 18 F-FDOPA resembles natural L-DOPA, which competes with large neutral amino acids in the plasma and is transported into the neurons by various amino acid transporters (8).…”

18F-DOPA PET/CT unravels malignant paraganglioma mimicking temporomandibular joint disorder

“…18 F-DOPA PET/CT, a recent hybrid anatomometabolic imaging technique, allows primary diagnosis, staging and restaging of a variety of neuroendocrine tumours, including pheochromocytoma and paraganglioma. 10,11 The detection rate is said to be superior to conventional MIBG scintigraphy 12 F-FDG PET/CT has very good values in this study, it is not recommended for first-line imaging because its uptake is not paraganglioma-specific. Furthermore, the anatomical resolution of PET images is clearly inferior to that of MRI and high-resolution contrastenhanced CT. 10,11 So investigations are completed with selective high-resolution CT or MRI.…”

Toward tailored medicine (and beyond): the phaeochromocytoma and paraganglioma model

“…F-DOPA is transported into neuroendocrine cells via the sodium-independent system L, in which a large neutral amino acid transporter (LAT1) protein linked to the glycoprotein CD98 is the principal mediator. DOPA can be decarboxylated to dopamine by L-amino acid decarboxylase (L-AADC), an enzyme widely expressed in differentiated NET [10]. In oncology, F-DOPA is under evaluation for the imaging of NET and neuroblastoma.…”