The effects of carbidopa on the metabolism of 6-[18F]fluoro-L-dopa in rats, monkeys and humans

The effects of carbidopa on the peripheral metabolism of 6-18F]fluoro-L-DOPA (FDOPA) were characterized in the rat, monkey and human along with its effects on cerebral FDOPA metabolism in the rat. After carbidopa pretreatment, FDOPA plasma metabolite profiles in all three species revealed extensive metabolism of FDOPA to 3-0-methyl-6-18F]-fluoro-L-DOPA (3-OMFD). In humans, there were significant increases in FDOPA plasma levels for 30 min and in 3-OMFD levels for 120 min after FDOPA administration. 6-18F]Fluorodopamine sulfate (FDA-sulfate) and 18F]fluoro-homovanillic acid (FHVA) levels were decreased, while at all times, free 6-18F]-fluorodopamine (FDA) and 6-18F]-3-4 dihydroxy-phenylacetic acid (FDOPAC) were not detected. In rat brain, the FDOPA metabolite profile at 30 min was significantly altered by carbidopa pretreatment; increases were noted for striatum FDA (700%) and 3-OMFD (230%), and for cerebellum FDOPA (370%) and 3-OMFD (300%). Thus, carbidopa pretreatment increased FDOPA plasma levels for a given FDOPA dose and essentially restricted peripheral FDOPA metabolism to 3-OMFD formation. The increase in FDOPA bioavailability to the brain resulted in greater selective FDA accumulation in striatum. As such, carbidopa pretreatment for FDOPA-positron emission tomography studies will significantly increase the amount of radioactivity that can be attributable to FDA in cerebral regions of interest.