Biodistribution of 18 F-AlF-NOTA-octreotide in Different Organs and Characterization of Uptake in Neuroendocrine Neoplasms

Purpose The aims of this study were threefold: [ 1 ] to describe the biodistribution of 18 F-AlF-NOTA-octreotide ( 18 F-OC) in normal organs; [ 2 ] to evaluate the range of uptake of NEN and benign lesions using the maximum standardized uptake value (SUV max ); and [ 3 ] to compare the difference in 18 F-OC uptake among tumors of different grades. Methods This study included 162 patients (67 females and 95 males) who received 18 F-OC positron emission tomography (PET)/computed tomography (CT), 128 of whom were diagnosed with neuroendocrine neoplasms (NENs). The SUV max and SUV mean of 18 F-OC were measured in 21 normal anatomical structures. We compared the differences among G1, G2, and G3 NENs, as well as between NENs and benign lesions. Results High physiological uptake of 18 F-OC (SUV max > 6.77) was detected in the spleen, adrenal gland, renal parenchyma, pituitary gland, and liver. Moderate uptake (SUV max 3.00–6.77) was found in the uncinate process of the pancreas (PU), prostate, thyroid, and uterus. Mild uptake (SUV max 1.34–3.00) was observed in the small intestine, pancreas (pancreas uptake except for the head of the pancreas), gallbladder, and transverse colon. The SUV max of NENs was higher than that of benign lesions, including fractures, inflamed tissue, reactive hyperplasia, and degenerative disease. However, overlap was noted between the two groups. The SUV max of 18 F-OC uptake by tumors was significantly correlated with tumor grade in primary lesions and those of the lymph node, bone, and other sites (all P < 0.01). Conclusions The results obtained from the majority of the samples in this study show the biodistribution of 18 F-OC in normal organs and have significance as a reference. Although some benign lesions show variable uptake, the uptake by these lesions is still different from that of NENs. NENs of different grades have differences in 18 F-OC uptake levels.