Diagnosis and localization of focal congenital hyperinsulinism by 18F-fluorodopa PET scan.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
[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.
Hardy
Olga T
OT
Division of Endocrinology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.
Hernandez-Pampaloni
Miguel
M
Saffer
Janet R
JR
Suchi
Mariko
M
Ruchelli
Eduardo
E
Zhuang
Hongming
H
Ganguly
Arupa
A
Freifelder
Richard
R
Adzick
N Scott
NS
Alavi
Abass
A
Stanley
Charles A
CA
D016001:Confidence Intervals; D044903:Congenital Hyperinsulinism / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007275:Injections, Intravenous; D008297:Male; D010179:Pancreas / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography / Q000379:methods*; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
C043437:fluorodopa F 18; D004295:Dihydroxyphenylalanine