title: Evaluation of [18F]fluoro-L-DOPA positron emission tomography-computed tomography for surgery in focal congenital hyperinsulinism.
abstract: BACKGROUND
  In congenital hyperinsulinism (CHI), the identification and precise localization of a focal lesion is essential for successful surgery.
  
  
  OBJECTIVE
  Our objective was to evaluate the predictive value and accuracy of integrated [18F]fluoro-L-DOPA ([18F]FDOPA) positron emission tomography (PET)-computed tomography (CT) for the surgical therapy of CHI.
  
  
  METHODS
  This was an observational study.
  
  
  METHODS
  The study was performed in the Department of Pediatric Surgery at a university hospital.
  
  
  METHODS
  From February 2005 to September 2007, 10 children with the clinical signs of CHI and an increased radiotracer uptake in a circumscribed area of the pancreas in the [18F]FDOPA PET-CT were evaluated.
  
  
  METHODS
  Guided by the [18F]FDOPA PET-CT report, all children underwent partial pancreatic resection, in two cases twice.
  
  
  METHODS
  Correlation of the anatomical findings at surgery with the report of the [18F]FDOPA PET-CT, and the results of surgery and clinical outcome were determined.
  
  
  RESULTS
  In nine children the intraoperative situation corresponded exactly to the description of the [18F]FDOPA PET-CT. A limited resection of the pancreas was curative in eight cases at the first surgery, in one case at the second intervention. We observed no diabetes mellitus or exocrine insufficiency in the follow up so far. In one child, hypoglycemia persisted even after two partial resections of the pancreatic head. Histological analysis finally revealed an atypical intermediate form of CHI.
  
  
  CONCLUSIONS
  The integrated [18F]FDOPA PET-CT is accurate to localize the lesion in focal CHI and is a valuable tool to guide the surgeon in limited pancreatic resection.
authors: Clinic for Pediatric Surgery, Institute for Pathology, Charité University Medicine Berlin, Campus Virchow Klinikum, Augustenburger Platz 1, Mittelallee 8, D-13353 Berlin, Germany. winfried.barthlen@charite.de
authors: Winfried
authors: W
authors: Barthlen
authors: Oliver
authors: O
authors: Blankenstein
authors: Harald
authors: H
authors: Mau
authors: Martin
authors: M
authors: Koch
authors: Claudia
authors: C
authors: Höhne
authors: Wolfgang
authors: W
authors: Mohnike
authors: Traugott
authors: T
authors: Eberhard
authors: Frank
authors: F
authors: Fuechtner
authors: Bettina
authors: B
authors: Lorenz-Depiereux
authors: Klaus
authors: K
authors: Mohnike
mesh_terms: D002675:Child, Preschool; D044903:Congenital Hyperinsulinism / Q000000981:diagnostic imaging / Q000601:surgery*; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives*; D005260:Female; D005462:Fluorine Radioisotopes; D006801:Humans; D007223:Infant; D008297:Male; D049268:Positron-Emission Tomography / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D005462:Fluorine Radioisotopes; C043437:fluorodopa F 18; D004295:Dihydroxyphenylalanine