DOI: 10.1007/s00259-017-3833-yPages: 278-282

Quantitative 18F-DOPA PET/CT in pheochromocytoma: the relationship between tumor secretion and its biochemical phenotype

1. Aix-Marseille University, Department of Endocrinology, Conception University Hospital

2. Aix-Marseille University, Department of Endocrine Surgery, Conception University Hospital

3. Aix-Marseille University, Department of Nuclear Medicine, La Timone University Hospital, European Center for Research in Medical Imaging

4. Aix-Marseille University, Laboratory of Molecular Biology, Conception Hospital & CNRS, CRN2M UMR 7286

5. Aix-Marseille University, Department of Public Health, EA3279 Self-perceived Health Assessment Research Unit, La Timone University

6. National Institutes of Health, Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health & Human Development

Correspondence to:
David Taïeb
Tel: +33 (0) 4-91-38-44-06




18F-FDOPA illustrates the properties of uptake and storage of catecholamines in pheochromocytomas (PHEOs). Until now, the relationship between 18F-FDOPA quantitative parameters and a PHEO secretory profile has not been specifically evaluated.

Materials and methods

Fifty-six patients (56% females, median age: 47.5 yrs) with non-metastatic PHEO, evaluated by 18F-FDOPA PET/CT, were included in this retrospective study. Forty-five patients had negative genetic testing (80.4%); five patients (8.9%) had RET, two patients (3.6%) had SDHB, two had SDHD (3.6%), one patient (1.8%) had NF1, and one patient had a VHL (1.8%) mutation. Correlation between 18F-FDOPA metabolic parameters (tumor SUVmax, tumor SUVmean, tumor SUVmax/liver SUVmax, MTV 42%, total lesion uptake), urinary metanephrines (MNs), and plasma chromogranin A (CgA) were evaluated.


All patients had positive 18F-FDOPA PET/CT. On univariate analysis, there was a strong correlation between all metabolic parameters and urinary MNs and plasma chromogranin A (CgA). The highest correlations were observed between total lesion (TL) uptake and the value of urinary MNs regardless of their nature (p = 8.10−15 and r = 0.80) and between MTV 42% and plasma CgA levels (p = 2.10−9, r = 0.74). On multivariate analysis, the correlation of uptake parameters and CgA levels did not persist further due to the relation of CgA and tumor diameter. A correlation between TL uptake and the normetanephrine/metanephrine ratio (NMN/MN) was also found, a finding that was in accordance with in vitro studies, which were found to have a higher catecholamine content in epinephrine producing PHEOs.


This retrospective study shows a correlation between 18F-FDOPA uptake, especially using TL uptake, urinary MNs, and a PHEO biochemical phenotype. This illustrates that beyond its localization value, 18F-FDOPA PET further enables PHEO characterization at a specific metabolic level.

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  • Accepted: Sep 6, 2017
  • Online: Sep 16, 2017

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