[18F FluoroLDopa

Several authors have investigated 6-[18F]fluoro-L-dopa (F-18-DOPA) in oncological patients to increase the specificity of PET. Dihydroxyphenylalanine (DOPA) has the potential to be used as a precursor of melanin synthesis. Ishiwata et al. (43) assessed F-18-DOPA uptake in mice bearing B16 melanomas and found that tracer uptake was correlated with melanogenesis. However, it is likely that F-18-DOPA primarily provides information about the transport of the tracer, because the F-18 label is removed after the first metabolic step when DOPA is labeled in the sixth-position (44). Perfusion, FDG, and F-18-DOPA kinetics were compared in 11 patients with metastatic melanoma by Dimitrakopoulou-Strauss et al. (44). Generally FDG uptake was 1.5-fold higher than the F-18-DOPA uptake in 18 of 22 metastases. The authors report that the F-18-DOPA uptake was not perfusion dependent and provided different information as compared with FDG. Jacob et al. (44) used F-18-DOPA and FDG in four patients with small cell carcinoma and noted a lower uptake of F-18-DOPA as compared to FDG. Besides malignant melanoma, F-18-DOPA does accumulate in endocrine tumors (Fig. 11). On the basis of the current literature data, F-18-DOPA seems to be a promising tracer for PET imaging in patients

Figure 11 FDG (left) and F-18-DOPA (right) image of a patient with liver metastases from an endocrine tumor following chemotherapeutic treatment. The metastases show a low FDG uptake and preferentially accumulate F-18-DOPA. (See color insert.)

with malignant melanoma and endocrine tumors, additional to FDG. Especially in patients following chemotherapeutic treatment, F-18-DOPA can provide additional information as compared to FDG, because FDG uptake can be low in these patients.

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