Diagnosis and Localization of Focal Congenital Hyperinsulinism by 18F-Fluorodopa PET Scan

To assess the accuracy of 18F-fluoro- l-dihydroxyphenylalanine ([ 18F]-DOPA) PET scans to diagnose focal versus diffuse disease and to localize focal lesions in infants with congenital hyperinsulinism. Twenty-four infants with hyperinsulinism unresponsive to medical therapy were studied. Patients we...

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Bibliographic Details
Published in:The Journal of pediatrics 2007-02, Vol.150 (2), p.140-145
Main Authors: Hardy, Olga T., Hernandez-Pampaloni, Miguel, Saffer, Janet R., Suchi, Mariko, Ruchelli, Eduardo, Zhuang, Hongming, Ganguly, Arupa, Freifelder, Richard, Adzick, N. Scott, Alavi, Abass, Stanley, Charles A.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Confidence Intervals
Congenital Hyperinsulinism - diagnostic imaging
Congenital Hyperinsulinism - physiopathology
Dihydroxyphenylalanine - analogs & derivatives
Female
General aspects
Humans
Infant
Infant, Newborn
Injections, Intravenous
Male
Medical sciences
Pancreas - diagnostic imaging
Positron-Emission Tomography - methods
Prospective Studies
Risk Assessment
Sensitivity and Specificity
Severity of Illness Index
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Summary:To assess the accuracy of 18F-fluoro- l-dihydroxyphenylalanine ([ 18F]-DOPA) PET scans to diagnose focal versus diffuse disease and to localize focal lesions in infants with congenital hyperinsulinism. Twenty-four infants with hyperinsulinism unresponsive to medical therapy were studied. Patients were injected intravenously with [ 18F]-DOPA, and PET scans were obtained for 1 hour. Images were coregistered with abdominal CT scans. The diagnosis of focal or diffuse hyperinsulinism was correct in 23 of the 24 cases (96%) and equivocal in 1 case. [ 18F]-DOPA PET identified focal areas of high uptake of radiopharmaceutical in 11 patients. Pathology results confirmed that all 11 had focal adenomatosis, and the locations of these lesions matched the areas of increased [ 18F]-DOPA uptake on the PET scans in all of the cases. [ 18F]-DOPA PET scans were 96% accurate in diagnosing focal or diffuse disease and 100% accurate in localizing the focal lesion. These results suggest that [ 18F]-DOPA PET imaging should be considered in all infants with congenital hyperinsulinism who need to have pancreatectomy.
ISSN:0022-3476
1097-6833
DOI:10.1016/j.jpeds.2006.08.028