Abstract
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Objectives: Congenital hyperinsulinism is the most common cause of hypoglycemia in early infancy and requires an aggressive treatment. The hyperinsulinism focal form can revert with a partial pancreatectomy, while the diffuse form requires a subtotal pancreatectomy. We propose a semi-automated method allowing the automated distinction between the two forms in Positron Emission Tomography (PET) Images.
Methods: We have applied the Local Means Analysis (LMA) segmentation method to 15 static 18F-DOPA PET images of infants affected either with the focal (12 cases) or with the diffuse (3 cases) form of hyperinsulinism. Focal lesions were located in the pancreas head (10 cases)or in the pancreas tail (2 cases). Histology provided a gold standard for our identification method. LMA segments the PET images into homogeneous regions, and then merge the regions according to their mean activity concentration. Focal lesions are expected not to merge with the rest of the pancreas, while the whole pancreas affected with a diffuse form should be associated to one unique region.
Results: The method provided within few minutes a correct segmentation of the lesions for 14 images on the 15. The unique failure concerned a focal lesion connected to the left kidney, which also presents a high activity. Moreover, the segmentation was able to distinguish the focal form from the diffuse one for each segmented image.
Conclusions: We have developed a fast and reliable method that provides an automated segmentation of the focal lesions, together with a semi-automated (a visual assessment of the segmentation is mandatory) identification of the hyperinsulinism form.
- Society of Nuclear Medicine, Inc.