Sex- and Age-Related Differences in Physiological [¹⁸F]FDOPA Uptake on Long Axial Field-of-View PET/CT Imaging

This retrospective quantitative data analysis study aimed to investigate sex- and age-related differences in the physiological distribution of [¹⁸F]FDOPA uptake in long axial field-of-view (LAFOV) PET images across a range of organs and tissues. A retrospective quantitative data analysis study of 106 anonymized PET/CT images acquired from vertex to mid-thigh with minimal abnormalities, divided in two gender groups and two age groups was used for this study. The mean and max lean body mass weighted standardized uptake values (SUL_mean), SUL_max), target-to-background ratios (TBR), and coefficients of variation (CoV) were used to quantify tracer uptake. Sex- and age-related differences in uptake were organ- and metric-specific. Most organs showed comparable uptake between males and females. However, males exhibited higher absolute uptake in metabolically active organs and females showed greater intra-organ heterogeneity. Aging was generally associated with increased tracer uptake and variability, especially in women, with the hip showing higher uptake in younger individuals. Statistically significant differences were most prominent in women and varied by organ and metric. In conclusion, both sex and age significantly influence [¹⁸F]FDOPA PET tracer uptake and variability in an organ- and metric-specific manner. Incorporating sex- and age-adjusted reference values may improve the accuracy and personalization of PET imaging in clinical and research settings.