title: Diagnostic performance of fluorine-18-dihydroxyphenylalanine positron emission tomography in diagnosing and localizing the focal form of congenital hyperinsulinism: a meta-analysis.
abstract: BACKGROUND
  We performed a meta-analysis on published data on the diagnostic performance of fluorine-18 dihydroxyphenylalanine ((18)F-DOPA) positron emission tomography (PET) in diagnosing and localizing focal congenital hyperinsulinism (CHI).
  
  
  METHODS
  A comprehensive computer literature search of studies published up to 31 January 2012 regarding (18)F-DOPA PET or PET/CT in patients with CHI was performed. Pooled sensitivity and specificity, area under the ROC curve and diagnostic odds ratio (DOR) of (18)F-DOPA PET or PET/CT in diagnosing focal CHI were calculated. The localization accuracy of focal CHI was also estimated. Seven studies comprising 195 CHI patients were included.
  
  
  RESULTS
  The pooled sensitivity and specificity of (18)F-DOPA PET or PET/CT in differentiating between focal and diffuse CHI were 89% (95% confidence interval [CI]:81-95%) and 98% (95% CI:89-100%), respectively. The DOR was 74.5 (95% CI:18-307). The area under the ROC curve was 0.95. The pooled accuracy of these functional imaging methods in localizing focal CHI was 80% (95% CI:71-88%).
  
  
  CONCLUSIONS
  In CHI patients, (18)F-DOPA PET or PET/CT demonstrated high sensitivity and specificity in differentiating between focal and diffuse CHI. (18)F-DOPA PET or PET/CT are accurate methods of localizing focal CHI. Nevertheless, possible sources of false-negative results for focal CHI should be kept in mind.
authors.affiliation: Institute of Nuclear Medicine, Catholic University of the Sacred Heart, Largo Gemelli, 8, Rome 00168, Italy. giorgiomednuc@libero.it
authors.forename: Giorgio
authors.initials: G
authors.lastname: Treglia
authors.forename: Paoletta
authors.initials: P
authors.lastname: Mirk
authors.forename: Alessandro
authors.initials: A
authors.lastname: Giordano
authors.forename: Vittoria
authors.initials: V
authors.lastname: Rufini
mesh_terms: D044903:Congenital Hyperinsulinism / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D004295:Dihydroxyphenylalanine / Q000031:analogs & derivatives*; D019317:Evidence-Based Medicine; D006801:Humans; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data*; D015995:Prevalence; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D019275:Radiopharmaceuticals; C043437:fluorodopa F 18; D004295:Dihydroxyphenylalanine