# Fluorodopa F-18

Source: https://nuclide.cc/drugs/f-18-fdopa/  
Nuclide record `f-18-fdopa` (Agent). Data CC BY-NC 4.0, attribute "Data from Nuclide (nuclide.cc)"; commercial use needs a licence.

## TL;DR

A tracer originally built to look at brain dopamine cells in suspected Parkinson's disease. Because certain hormone-producing tumours use the same chemical machinery, doctors also use it, off-label, to find those tumours -- especially adrenal gland tumours called pheochromocytoma.

## Summary

Fluorodopa F 18 Injection was approved by FDA in 2019 (NDA 200655, sponsor The Feinstein Institutes for Medical Research) solely for PET imaging of dopaminergic nerve terminals in adults with suspected Parkinsonian syndromes; that is a neurological indication, not an oncological one, and it is the only indication on the US label. The recommended dose is 185 MBq (5 mCi) IV.

In oncology, 18F-FDOPA is used off-label, but with strong evidence and explicit guideline support: the 2019 EANM/SNMMI procedure standard for phaeochromocytoma and paraganglioma names 18F-FDOPA (alongside 123I-MIBG) as a first-line tracer, ahead of 68Ga-DOTATATE and 18F-FDG. In a prospective head-to-head study of 97 patients, FDOPA detected all 55 confirmed pheochromocytomas versus 25 of 55 for 68Ga-DOTATOC (sensitivity 100% vs 49%, p<0.0001), though DOTATATE-family tracers retain an edge for extra-adrenal and SDHx-related metastatic disease. FDOPA is also used, again off-label, in brain tumour imaging (glioma grading and recurrence, alongside FET) under joint EANM/EANO/RANO/SNMMI amino-acid PET guidelines.

## Fields

- Kind: Agent
- Status: approved
- Last checked: 2026-09-22
- Also known as: 18F-FDOPA; 6-[18F]fluoro-L-DOPA; Fluorodopa F 18 Injection
- Tags: amino acid PET; off-label oncology use; PPGL
- Modality: PET tracer
- Mechanism: A fluorinated analogue of L-DOPA that is taken up by the amino-acid transport system and converted by aromatic L-amino-acid decarboxylase (AADC) into a trapped dopamine analogue. Dopaminergic neurons take it up for the FDA-approved neurological indication; the same AADC pathway is highly active in cells of neural-crest and neuroendocrine origin, which is why the tracer also concentrates strongly in pheochromocytoma, paraganglioma and other well-differentiated neuroendocrine tumours.
- Approvals: US 2019: PET imaging to visualise dopaminergic nerve terminals in the striatum in adults with suspected Parkinsonian syndromes (neurological indication; oncology use is off-label)
- Dosing: Intravenous injection over 1 minute; 185 MBq (5 mCi) in adults

## Sources

- FDA label: Fluorodopa F 18 Injection: https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/200655s000lbl.pdf
- Prospective comparison of 18F-FDOPA and 68Ga-DOTATOC PET/CT in pheochromocytoma/paraganglioma (2023): https://pmc.ncbi.nlm.nih.gov/articles/PMC10728412/
- EANM/SNMMI 2019 practice guideline for radionuclide imaging of phaeochromocytoma and paraganglioma: https://snmmi.org/common/Uploaded%20files/Web/Clinical%20Practice/Procedure%20Standards/2019/EANM%20SNMMI%20guideline%20on%20radionuclide%20imaging%20of%20phaeochromocytoma%20and%20paraganglioma.pdf

## Connected records

- drugs: [Copper-64 dotatate](https://nuclide.cc/drugs/cu-64-dotatate/), [Floretyrosine F-18 (FET)](https://nuclide.cc/drugs/f-18-fet/), [Gallium-68 edotreotide (DOTATOC)](https://nuclide.cc/drugs/ga-68-dotatoc/), [Iobenguane I-123](https://nuclide.cc/drugs/i-123-mibg/)
- isotopes: [Fluorine-18](https://nuclide.cc/isotopes/f-18/), [Gallium-68](https://nuclide.cc/isotopes/ga-68/), [Iodine-123](https://nuclide.cc/isotopes/i-123/)
- indications: [Glioma & glioblastoma](https://nuclide.cc/indications/glioblastoma/), [Metastatic pheochromocytoma and paraganglioma](https://nuclide.cc/indications/metastatic-ppgl/), [Neuroendocrine tumours](https://nuclide.cc/indications/neuroendocrine/), [Pheochromocytoma and paraganglioma (PPGL)](https://nuclide.cc/indications/pheochromocytoma-paraganglioma/)
- technologies: [PET (positron emission tomography)](https://nuclide.cc/technologies/pet/), [PET/CT](https://nuclide.cc/technologies/pet-ct/)

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