Abstract
Persistent hyperinsulinemic hypoglycemia (PHH) is caused by solitary benign insulinoma or hyperplasia of pancreatic beta cells. In infants, PHH is caused by functionally defective hyperplastic beta cells, which are either diffusely or focally distributed in the pancreas. In adults, insulinoma is the most common cause of PHH, but recently, an increasing number of beta-cell hyperplasias has been reported among adults. The cause of adult beta-cell hyperplasia is not known. Whether the increased use of bariatric surgery in the treatment of severe obesity plays a role here is under investigation. Accurate localization of disease focus in both insulinoma and focal beta-cell hyperplasia provides an important support for surgery, especially as the use of laparoscopic surgery has increased. Conventional imaging of these challenging pancreatic lesions has evolved during recent years, but current imaging methods still lack sufficient sensitivity or are invasive. In most pancreatic neuroendocrine tumors (NETs), the usefulness of positron emission tomography (PET) with fluorine-labeled fluorodeoxyglucose ([18F]FDG) for lesion detection is limited because of the low glucose turnover of these tumors. Based on the capacity of pancreatic beta cells to take up and decarboxylate amine precursors, several investigators have studied patients with pancreatic NETs using aminoacid precursors, such as [18F]dihydroxyphenylalanine (DOPA) and [11C]hydroxytryptophan (5-HTP), in an attempt to increase the sensitivity of PET scanning. Another characteristic of NETs is the expression of somatostatin receptors, and thus encouraging studies with somatostatin receptor imaging with [18Ga]-labeled somatostatin analogs have emerged as a new interesting imaging tool for the diagnosis of pancreatic NETs. This article provides an overview of our experiences and the current literature on PET imaging in patients with PHH caused by insulinoma or beta-cell hyperplasia.
Keywords: Beta-cell hyperplasia, nesidioblastosis, insulinoma, PET, dihydroxyphenylalanine
Current Pharmaceutical Design
Title: Clinical PET Imaging of Insulinoma and Beta-Cell Hyperplasia
Volume: 16 Issue: 14
Author(s): S. Kauhanen, M. Seppanen, H. Minn and P. Nuutila
Affiliation:
Keywords: Beta-cell hyperplasia, nesidioblastosis, insulinoma, PET, dihydroxyphenylalanine
Abstract: Persistent hyperinsulinemic hypoglycemia (PHH) is caused by solitary benign insulinoma or hyperplasia of pancreatic beta cells. In infants, PHH is caused by functionally defective hyperplastic beta cells, which are either diffusely or focally distributed in the pancreas. In adults, insulinoma is the most common cause of PHH, but recently, an increasing number of beta-cell hyperplasias has been reported among adults. The cause of adult beta-cell hyperplasia is not known. Whether the increased use of bariatric surgery in the treatment of severe obesity plays a role here is under investigation. Accurate localization of disease focus in both insulinoma and focal beta-cell hyperplasia provides an important support for surgery, especially as the use of laparoscopic surgery has increased. Conventional imaging of these challenging pancreatic lesions has evolved during recent years, but current imaging methods still lack sufficient sensitivity or are invasive. In most pancreatic neuroendocrine tumors (NETs), the usefulness of positron emission tomography (PET) with fluorine-labeled fluorodeoxyglucose ([18F]FDG) for lesion detection is limited because of the low glucose turnover of these tumors. Based on the capacity of pancreatic beta cells to take up and decarboxylate amine precursors, several investigators have studied patients with pancreatic NETs using aminoacid precursors, such as [18F]dihydroxyphenylalanine (DOPA) and [11C]hydroxytryptophan (5-HTP), in an attempt to increase the sensitivity of PET scanning. Another characteristic of NETs is the expression of somatostatin receptors, and thus encouraging studies with somatostatin receptor imaging with [18Ga]-labeled somatostatin analogs have emerged as a new interesting imaging tool for the diagnosis of pancreatic NETs. This article provides an overview of our experiences and the current literature on PET imaging in patients with PHH caused by insulinoma or beta-cell hyperplasia.
Export Options
About this article
Cite this article as:
Kauhanen S., Seppanen M., Minn H. and Nuutila P., Clinical PET Imaging of Insulinoma and Beta-Cell Hyperplasia, Current Pharmaceutical Design 2010; 16 (14) . https://dx.doi.org/10.2174/138161210791164090
DOI https://dx.doi.org/10.2174/138161210791164090 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Radionuclides Used in Nuclear Medicine Therapy – From Production to Dosimetry
Current Medical Imaging Repurposing of Anticancer Drugs for the Treatment of Bacterial Infections
Current Topics in Medicinal Chemistry Radiobromine-Labelled Tracers for Positron Emission Tomography: Possibilities and Pitfalls
Current Radiopharmaceuticals “Antisurvival” Factor Treatment for Hormone Refractory Prostate Cancer: Secondary Hormonal Ablation Using Somatostatin Analogs
Current Cancer Therapy Reviews How Do Microtubule-Targeted Drugs Work? An Overview
Current Cancer Drug Targets Cellular Localisation of Chromogranins and Processed Products in the Diffuse Neuroendocrine System and Related Tumours
Current Medicinal Chemistry - Immunology, Endocrine & Metabolic Agents Chromogranin A and the Endothelial Barrier Function
Current Medicinal Chemistry Current and Emerging Therapies in Neuroendocrine Tumors: Impact of Genetic Targets on Clinical Outcomes
Clinical Cancer Drugs Bcl-2 Inhibitors: Emerging Drugs in Cancer Therapy
Current Medicinal Chemistry HtrA Serine Proteases as Potential Therapeutic Targets in Cancer
Current Cancer Drug Targets Cancer Imaging Agents for Positron Emission Tomography: Beyond FDG
Current Medical Imaging The Diagnosis of Large Airway Pathology and the Role of Rigid Bronchoscopy
Current Respiratory Medicine Reviews Recent Patents Related to Phosphorylation Signaling Pathway on Cancer
Recent Patents on DNA & Gene Sequences TRAIL Gene Therapy: From Preclinical Development to Clinical Application
Current Gene Therapy Optical and Multimodal Peptide-Based Probes for In Vivo Molecular Imaging
Anti-Cancer Agents in Medicinal Chemistry Antihistamines as Important Tools for Regulating Inflammation
Current Medicinal Chemistry - Anti-Inflammatory & Anti-Allergy Agents Identifying Biomarkers of Lung Cancer in the Post-Genomic Era
Current Pharmacogenomics Imaging of Spinal Bone Tumors: Principles and Practice
Current Medical Imaging The Human L1 Element: A Potential Biomarker in Cancer Prognosis, Current Status and Future Directions
Current Molecular Medicine Importance and Limitations of Chemotherapy Among the Available Treatments for Gastrointestinal Tumours
Anti-Cancer Agents in Medicinal Chemistry