ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2008) 16 P587

Evaluation of Intergrated [18F]FDOPA-PET/CT for identification of focal forms of Congenital Hyperinsulinism (CHI)

Oliver Blankenstein1, Klaus Mohnike2, Khalid Hussain3, Peter Kuehnen1, Winfried Barthlen4, Frank Fuechtner6 & Wolfgang Mohnike5

1Paediatric Endocrinology, Charité-Universitätsmedizin Berlin, Berlin, Germany; 2Paediatric Department, Otto von Guericke Universität, Magdeburg, Germany; 3National Institute for Child Health, Great Ormond Street Hospital, London, UK; 4Peadiatric Surgery, Charité, Berlin, Germany; 5DiagnostischTherapeutisches Zentrum am Frankfurter Tor, Berlin, Germany; 6Inst. for Radiopharmacy, Forschungszentrum Dresden Rossendorf, Dresden, Germany.

Objective: CHI is the most frequent cause of severe hypoglycaemia in infants. Two distinct anatomical forms have been described which require different therapeutic strategies. We evaluated the predictive value and accuracy of integrated [18F]FDOPA-PET/CT as a new tool in identification of focal lesions in an observational study.

Patients and methods: From 2005 to 2007, 73 infants and children from the UK (30) and Germany (42) with CHI were examined with [18F]FDOPA-PET/CT for localization diagnostic. Since 2007 a high-resolution 64line CT-scan were used. A special angiographic enhancement protocol was developed and anatomical landmarks were identified to improve the localization within the organ and to guide the surgeon.

Results: In 69 of 72 patients a differentiation between focal and diffuse form was possible. Focal cases were treated surgically. The diagnosis was histological confirmed in 22 of 23 focal cases. In 9 cases the precise localization by the [18F]FDOPA-PET/CT enabled minimal invasive laparoscopic surgery.

Subtotal pancreas resection was necessary in 3 diffuse cases while the others are manageable with medical therapy so far. We present the metabolic and neurologic outcome of the cases.

Conclusion: Integrated [18F]FDOPA-PET/CT was able to discriminate between focal and diffuse forms in 95% of the cases and accurately localize the lesion in focal CHI. It is a valuable tool to support the determination of further therapy (medical or surgical) and finally to guide the surgeon in limited pancreatic resection.

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