Abstract
PurposeThis study evaluates the prevalence of cardiac metastases in patients with serotonin producing neuroendocrine tumours (NET), examined with 18F-FDOPA PET/CT, and the relationship of these metastases to the presence of carcinoid heart disease (CHD) based on echocardiography.BackgroundCHD occurs in patients with serotonin producing NET. The diagnostic method of choice remains echocardiography. The precise prevalence of cardiac metastases is unknown given the limitations of standard technologies. Nuclear medicine modalities have the potential to visualize metastases of NET.MethodsAll patients who underwent 18F-FDOPA PET/CT because of serotonin producing NET between November 2009 and May 2012 were retrospectively analyzed. The presence of cardiac metastasis was defined as myocardial tracer accumulation higher than the surrounding physiological myocardial uptake. Laboratory tests and transthoracic echocardiography (TTE) results were digitally collected.Results116 patients (62 male) underwent 18F-FDOPA PET/CT, mean age was 61±13 years. TTE was performed in 79 patients. Cardiac metastases were present in 15 patients, of which 10 patients also underwent TTE. One patient had both cardiac metastasis (only on 18F-FDOPA PET/CT) and echocardiographic signs of CHD. There were no differences in echocardiographic parameters for CHD between patients with and without cardiac metastases. TTE in none of the 79 patients showed cardiac metastases.ConclusionThe prevalence of cardiac metastases detected with 18F-FDOPA PET/CT in this study is 13%. 18F-FDOPA PET/CT can visualize cardiac metastases in serotonin producing NET patients. There appears to be no relationship between the presence of cardiac metastases and TTE parameters of CHD.
Highlights
Neuroendocrine tumours (NET) are rare but well-defined neuroendocrine malignancies, with a low worldwide incidence; approximately 1–2 per 100,000 persons [1]
Cardiac metastases were present in 15 patients, of which 10 patients underwent transthoracic echocardiography (TTE)
There were no differences in echocardiographic parameters for carcinoid heart disease (CHD) between patients with and without cardiac metastases
Summary
Neuroendocrine tumours (NET) are rare but well-defined neuroendocrine malignancies, with a low worldwide incidence; approximately 1–2 per 100,000 persons [1]. The overall sensitivity of 18F-FDOPA PET/CT for the detection of (metastatic) NET lesions is higher than that of SRS [2] All these nuclear medicine modalities have the potential to visualize tracer uptake in myocardial metastases in patient with NET [3,4]. CHD, present in up to 60% of patients with carcinoid syndrome, is characterized by plaque-like endocardial deposits of fibrous tissue on the ventricular aspect of the tricuspid valve leaflets, the arterial side of the pulmonary valve cusps, and in the right atrium, and right ventricle [5,6]. Nuclear medicine modalities have the potential to visualize metastases of NET
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