F-Tryptophan PET/CT in Human Cancers

Inclusion criteria

• Age ≥18 years.
• Targeted lesion (tumor) is at least 1 cm in diameter as shown by clinical imaging.
• Patient is able to lie in the PET/CT scanner for at least 70 minutes while undergoing scanning.
• Women of childbearing potential must not be pregnant or breastfeeding.
• Recent anatomic imaging with visible disease (tumor) for comparison with the PET/CT. .
• Physical exam within 28 days of PET imaging, CBC and Multiphasic (including electrolytes, BUN, creatinine, total bilirubin, AST and ALT) within 14 days.
• Patients must sign an informed consent indicating that they are aware of the investigational nature of this study.
• Inclusion Criteria Specific for Intracranial Tumors
• \- Clinical and MRI diagnosis of an intracranial lesion suspicious for a brain tumor, including gliomas or metastatic brain tumors; primary, residual, or recurrent brain tumors (judged by clinical imaging) will qualify.
• Inclusion Criteria Specific for Extracranial Neuroendocrine Tumors:
• Histopathologically confirmed, well-differentiated metastatic neuroendocrine tumor.
• ECOG performance status of 2 or better.
• Patients receiving stable-dose somatostatin analogs (SSAs, long-acting release \[LAR\], depot) for \>3 months before enrollment may be enrolled on the study, but such treatment is not required.
• Inclusion Criteria specific for Extracranial Primary Breast tumors:
• Clinical and radiological diagnosis of a breast cancer
• ECOG performance status of 2 or better.
• Inclusion Criteria specific for Rectal tumors:
• Histologically confirmed colorectal cancer, which is located in the rectum.
• ECOG performance status of 2 or better.

Exclusion criteria

• Patients who are pregnant or lactating are excluded.
• Exclusion Criteria Specific for Intracranial Tumors:
• Severe increased intracranial pressure, status epilepticus, or other symptoms requiring emergency or urgent intervention.
• Tumor surgery or radiation within 1 month prior to the PET scan
• Exclusion Criteria Specific for Extracranial Neuroendocrine Tumors:
• Tumor-directed therapy within 3 months to the area of planned imaging.
• Ongoing treatment with a targeted agent (e.g., sunitinib or everolimus) or receiving cytotoxic chemotherapy (e.g., capecitabine or temozolomide).
• Use of telotristat ethyl (a tryptophan-hydroxylase inhibitor) within one month.
• Exclusion Criteria for Extracranial Primary Breast tumors:
• Recent (within 1 month) tumor resection or radio-chemotherapy (acute/subacute post-treatment inflammatory changes may cause false positive increases on PET).
• Exclusion Criteria for Rectal tumors:
• Active inflammatory bowel disease (Crohn's or Ulcerative colitis) involving the rectum.