Impact of residual 18F-fluoride in 18F-FDOPA for the diagnosis of neuroblastoma

Ya Yao Huang, Kai Yuan Tzen, Yen Lin Liu, Ching Hong Chiu, Chia Ling Tsai, Hsiang Ping Wen, Kuang Hua Tang, Chien Chu Liu, Chyng Yann Shiue

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


Objective: PET imaging with 18F-FDOPA has been successfully applied in the diagnosis and surveillance of neuroblastoma (NB) by targeting the overexpression of aromatic l-amino acid decarboxylase. This study aims to assess the impact of residual 18F-fluoride on 18F-FDOPA PET in NB and to implement a method to maintain low 18F-fluoride content in future studies. Methods: Automatic synthesis of 18F-FDOPA was based on the electrophilic method using TRACERlab FXFE module. Radio-TLC was employed to determine residual 18F-fluoride levels. We analyzed the impact of residual 18F-fluoride on the images of 35 patients undergoing 18F-FDOPA PET at initial diagnosis and/or follow-ups of NB. Results: In 35 batches of 18F-FDOPA products from 9/28/2010 to 07/27/2011, the mean residual 18F-fluoride level was 4.4 % (range 0.2–19.1 %). Residual 18F-fluoride level ≥4.0 % was associated with dense uptake in the growth plates, skull, and pelvis on PET scans, which may interfere with the interpretation of 18F-FDOPA imaging in NB. By applying stringent restraints in 18F-FDOPA production, including regular renewal of reagents, exclusive use  of NH4OH, and timely replacement of HPLC column, the incidence of 18F-FDOPA batches with residual 18F-fluoride level ≥4.0 % was reduced from 33 to 4 % (P < 0.0001) during 7/30/2011–4/29/2013. Conclusion: By monitoring residual 18F-fluoride levels and keeping stringent restraint procedures, low 18F-fluoride content was achieved in most batches of 18F-FDOPA, which diminished false-positive skeletal uptake. An appropriate upper limit of 18F-fluoride level is suggested to be included in the criteria of routine quality control of 18F-FDOPA productions.

Original languageEnglish
Pages (from-to)489-498
Number of pages10
JournalAnnals of Nuclear Medicine
Issue number6
Publication statusPublished - Jul 25 2015


  • F-Fluoride
  • Metastasis
  • Neuroblastoma

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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