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Images from 18F-DOPA Scan in Congenital Hyperinsulinism: Not Always a Clue for Diagnosis

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Abstract

Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycaemia in childhood (Horm Res 70:65-72, 2008; J Clin Endocr Metab 93:869-875, 2008). 18−Fluoro-L-dihydroxy-phenylalanine (18F-DOPA) positron emission tomography (PET) can detect areas of increased activity in the pancreas and may differentiate focal from diffuse CHI (J Clin Endocr Metab 93:869-875, 2008; Radiology 253:216-222, 2009). We here report the case of a girl who complained of recurrent episodes of severe hypoglycaemia despite previous partial pancreatectomy. To evaluate the need for additional surgical intervention, we performed 18F-DOPA PET/computed tomography (CT), which showed a focal lesion corresponding to the anatomical region of the pancreatic tail. On the other hand, abdominal magnetic resonance imaging (MRI) clearly demonstrated that the 18F-DOPA uptake was in a loop of bowel occupying the previous surgical bed. Our case highlights that bowel uptake can be a possible pitfall in the interpretation of 18F-DOPA PET/CT in children affected by CHI, suggesting that when 18F-DOPA PET/CT results do not fit the clinical picture, magnetic resonance imaging (MRI) may allow a more accurate correlation of the radiotracer activity with the underlying anatomical or pathological structure.

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References

  1. Mohnike K, Blankenstein O, Minn H, et al. [18F]-DOPA positron emission tomography for preoperative localization in congenital hyperinsulinism. Horm Res. 2008;70:65–72.

    Article  CAS  PubMed  Google Scholar 

  2. Barthlen W, Blankenstein O, Mau H, et al. Evaluation of [18F]fluoro-L-DOPA positron emission tomography-computed tomography for surgery in focal congenital hyperinsulinism. J Clin Endocrinol Metab. 2008;93:869–75.

    Article  CAS  PubMed  Google Scholar 

  3. Capito C, Khen-Dunlop N, Ribeiro MJ, et al. Value of 18F-fluoro-L-dopa PET in the preoperative localization of focal lesions in congenital hyperinsulinism. Radiology. 2009;253:216–22.

    Article  PubMed  Google Scholar 

  4. Chondrogiannis S, Marzola MC, Al-Nahhas A, et al. Normal biodistribution pattern and physiologic variants of 18F-DOPA PET imaging. Nucl Med Commun. 2013;34:1141–9.

    CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgment

The authors are grateful to the members of the Association “Il Castello dei Sorrisi” (Verona, Italy) for their kind help and cooperation in the patient assistance.

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Authors and Affiliations

  1. Inherited Metabolic Diseases Unit, Department of Paediatrics, Regional Centre for Newborn Screening, Diagnosis and Treatment of Inherited Metabolic Diseases and Congenital Endocrine Diseases, Azienda Ospedaliera Universitaria Integrata, Piazzale Ludovico Antonio Scuro, 10, 37134, Verona, Italy

    Evelina Maines, Laura Baggio & Andrea Bordugo

  2. Paediatric Surgery Unit, Department of Surgical Sciences, “Giambattista Rossi” Hospital, University of Verona, Verona, Italy

    Luca Giacomello

  3. Department of Radiology, “Giambattista Rossi” Hospital, University of Verona, Verona, Italy

    Mirko D’Onofrio

  4. Department of Nuclear Medicine, Ospedale Sacro Cuore Don Calabria, Negrar, University of Verona, Verona, Italy

    Matteo Salgarello

  5. Division of Paediatric Endocrinology, Paediatric Clinic, Department of Life and Reproduction Sciences, “Giambattista Rossi” Hospital, University of Verona, Verona, Italy

    Rossella Gaudino

Authors
  1. Evelina Maines
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  2. Luca Giacomello
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  3. Mirko D’Onofrio
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  4. Matteo Salgarello
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  5. Rossella Gaudino
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  6. Laura Baggio
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  7. Andrea Bordugo
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Corresponding author

Correspondence to Evelina Maines.

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Conflict of Interest

Evelina Maines, Luca Giacomello, Mirko D’Onofrio, Matteo Salgarello, Rossella Gaudino, Laura Baggio and Andrea Bordugo declare that they have no conflicts of interests.

Ethical Statement

The study has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Written informed consent was obtained from the patient’s mother for publication of this report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. The identity of the patient has been protected.

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Maines, E., Giacomello, L., D’Onofrio, M. et al. Images from 18F-DOPA Scan in Congenital Hyperinsulinism: Not Always a Clue for Diagnosis. Nucl Med Mol Imaging 51, 362–363 (2017). https://doi.org/10.1007/s13139-016-0434-9

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  • DOI: https://doi.org/10.1007/s13139-016-0434-9

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