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Cancers 2012, 4(1), 100-112; doi:10.3390/cancers4010100

PET-Guided Surgery — High Correlation between Positron Emission Tomography with 11C-5-Hydroxytryptophane (5-HTP) and Surgical Findings in Abdominal Neuroendocrine Tumours

1
Departments of Medical Sciences, Uppsala University, Uppsala SE-751 85, Sweden
2
Department of Radiology, Karolinska Hospital, Institution of Molecular Medicine and Surgery, Karolinska Institute, Stockholm SE-171 77, Sweden
3
Department of Radiology, Uppsala University Hospital, Uppsala SE-751 85, Sweden
4
Department of Surgical Sciences, Uppsala University, Uppsala SE-751 85, Sweden
*
Author to whom correspondence should be addressed.
Received: 29 November 2011 / Revised: 29 January 2012 / Accepted: 30 January 2012 / Published: 8 February 2012
(This article belongs to the Special Issue Neuroendocrine Tumors)
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Abstract

Positron emission tomography (PET) with 11C-labeled 5-hydroxytryptophane (5-HTP) is a sensitive technique to visualize neuroendocrine tumours (NETs), due to high intracellular uptake of amine-precursors like L-dihydroxyphenylalanine (L-DOPA) and 5-HTP. NETs are often small and difficult to localize in spite of overt clinical symptoms due to hormonal excess. In our study, 38 consecutive NET patients underwent 11C-5-HTP-PET and morphological imaging by CT within 12 weeks prior to surgery. Surgical, histopathological and 5-HTP PET findings were correlated. 11C-5-HTP-PET corresponded to the surgical findings in 31 cases, was false negative in six, and true negative in one case resulting in 83.8% sensitivity and 100% specificity. Positive predicted value was 100%. In 11 patients 11C-5-HTP-PET was the only imaging method applied to localize the tumour. Thus, we could demonstrate that functional imaging by 11C-5-HTP-PET in many cases adds vital preoperative diagnostic information and in more than every fourth patient was the only imaging method that will guide the surgeon in finding the NET-lesion. Although the present results demonstrates that 11C-5-HTP may be used as an universal NET tracer, the sensitivity to visualize benign insulinomas and non functioning pancreatic NETs was lower.
Keywords: neuroendocrine tumour; positron emission tomography; hydroxytryptophane; insulinoma; surgery neuroendocrine tumour; positron emission tomography; hydroxytryptophane; insulinoma; surgery
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).

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MDPI and ACS Style

Örlefors, H.; Sundin, A.; Eriksson, B.; Skogseid, B.; Öberg, K.; Åkerström, G.; Hellman, P. PET-Guided Surgery — High Correlation between Positron Emission Tomography with 11C-5-Hydroxytryptophane (5-HTP) and Surgical Findings in Abdominal Neuroendocrine Tumours. Cancers 2012, 4, 100-112.

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