RT Journal Article
SR Electronic
T1 Characterization of Hyperinsulinism in Infancy Assessed with PET and <sup>18</sup>F-Fluoro-<span class="sc">l</span>-DOPA
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 560
OP 566
VO 46
IS 4
A1 Ribeiro, Maria-João
A1 De Lonlay, Pascale
A1 Delzescaux, Thierry
A1 Boddaert, Nathalie
A1 Jaubert, Francis
A1 Bourgeois, Sandrine
A1 Dollé, Frédéric
A1 Nihoul-Fékété, Claire
A1 Syrota, André
A1 Brunelle, Francis
YR 2005
UL http://jnm.snmjournals.org/content/46/4/560.abstract
AB Hyperinsulinism (HI) of infancy is a neuroendocrine disease secondary to either focal adenomatous hyperplasia or a diffuse abnormality of insulin secretion of the pancreas. HI with focal lesions can revert by selective surgical resection in contrast to the diffuse form, which requires subtotal pancreatectomy when resistant to medical treatment. Neuroendocrine diseases are a heterogeneous group of entities with the ability to take up amine precursors and to convert them into biogenic amines. Therefore, the aim of this study was (a) to evaluate the use of PET with 18F-fluoro-l-dihydroxyphenylalanine (18F-fluoro-l-DOPA) and (b) to distinguish between focal and diffuse HI. Methods: Fifteen patients (11 boys, 4 girls) with neonatal HI were enrolled in this study. All patients fasted for at least 6 h before the PET examination and their medication was discontinued for at least 72 h. The examination was performed under light sedation (pentobarbital associated with or without chloral). The dynamic acquisition started 45–65 min after the injection of 18F-fluoro-l-DOPA (4.0 MBq/kg weight). Four or 6 scans of 5 min each (2 or 3 steps according to the height of the patient) were acquired from the neck to the upper legs. Results: An abnormal focal pancreatic uptake of 18F-fluoro-l-DOPA was observed in 5 patients, whereas a diffuse uptake of the radiotracer was observed in the pancreatic area of the other patients. All patients with focal radiotracer uptake and also 4 of 10 patients with pancreatic diffuse radiotracer accumulation, unresponsive to medical treatment, underwent surgery. The histopathologic results confirmed the PET findings—that is, focal versus diffuse HI. Conclusion: The results of this study suggest that 18F-fluoro-l-DOPA could be an accurate noninvasive technique to distinguish between focal and diffuse forms of HI.