Abstract

BackgroundAn unknown location hampers removal of pancreatic tumours. We studied the effects of enzyme inhibitors on the uptake of 6-[18F]fluoro-l-3,4-dihydroxyphenylalanine ([18F]FDOPA) in the pancreas, aiming at improved imaging of pancreatic adenocarcinoma.MethodsMice bearing orthotopic BxPC3 pancreatic adenocarcinoma were injected with 2-deoxy-2-[18F]fluoro-d-glucose ([18F]FDG) and scanned with positron emission tomography/computed tomography (PET/CT). For [18F]FDOPA studies, tumour-bearing mice and sham-operated controls were pretreated with enzyme inhibitors of aromatic amino acid decarboxylase (AADC), catechol-O-methyl transferase (COMT), monoamine oxidase A (MAO-A) or a combination of COMT and MAO-A. Mice were injected with [18F]FDOPA and scanned with PET/CT. The absolute [18F]FDOPA uptake was determined from selected tissues using a gamma counter. The intratumoural biodistribution of [18F]FDOPA was recorded by autoradiography. The main [18F]FDOPA metabolites present in the pancreata were determined with radio-high-performance liquid chromatography.Results[18F]FDG uptake was high in pancreatic tumours, while [18F]FDOPA uptake was highest in the healthy pancreas and significantly lower in tumours. [18F]FDOPA uptake in the pancreas was lowest with vehicle pretreatment and highest with pretreatment with the inhibitor of AADC. When mice received COMT + MAO-A inhibitors, the uptake was high in the healthy pancreas but low in the tumour-bearing pancreas.ConclusionsCombined use of [18F]FDG and [18F]FDOPA is suitable for imaging pancreatic tumours. Unequal pancreatic uptake after the employed enzyme inhibitors is due to the blockade of metabolism and therefore increased availability of [18F]FDOPA metabolites, in which uptake differs from that of [18F]FDOPA. Pretreatment with COMT + MAO-A inhibitors improved the differentiation of pancreas from the surrounding tissue and healthy pancreas from tumour. Similar advantage was not achieved using AADC enzyme inhibitor, carbidopa.

Highlights

  • An unknown location hampers removal of pancreatic tumours

  • The aim of this study was to improve the detection of pancreatic adenocarcinoma using positron emission tomography (PET)

  • Carbidopa pretreatment increased the uptake in the pancreata in both sham-operated and tumour-bearing mice compared with vehicle treatment, but the difference between the sham-operated and tumour-bearing mice was not high enough to separate the healthy pancreas from the tumourbearing pancreas (Figure 2)

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Summary

Introduction

We studied the effects of enzyme inhibitors on the uptake of 6-[18F]fluoro-L-3,4-dihydroxyphenylalanine ([18F]FDOPA) in the pancreas, aiming at improved imaging of pancreatic adenocarcinoma. [18F]FDG is taken up into cells by glucose transporters, where it subsequently undergoes phosphorylation by hexokinase-1 into [18F]FDG-6-phosphate. The most frequently used positron emission tomography (PET) tracer for tumour imaging is the glucose analogue, 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG). This tracer is efficiently taken up by a variety of tumour cells and reflects increased glucose metabolism [2,3]. Chronic pancreatitis is recognised as the most common reason for false-positive [18F]FDG-PET tumour findings in the pancreas [2,6]

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