Images from ¹⁸F-DOPA Scan in Congenital Hyperinsulinism: Not Always a Clue for Diagnosis
10.1007/s13139-016-0434-9
- Author:
Evelina MAINES
1
;
Luca GIACOMELLO
;
Mirko D'ONOFRIO
;
Matteo SALGARELLO
;
Rossella GAUDINO
;
Laura BAGGIO
;
Andrea BORDUGO
Author Information
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@gmail.com
- Publication Type:Case Report
- Keywords:
Congenital hyperinsulinism;
Positron emission tomography;
Pancreatectomy;
Magnetic resonance imaging
- MeSH:
Child;
Congenital Hyperinsulinism;
Diagnosis;
Female;
Hand;
Humans;
Magnetic Resonance Imaging;
Pancreas;
Pancreatectomy;
Positron-Emission Tomography;
Positron-Emission Tomography and Computed Tomography;
Tail
- From:Nuclear Medicine and Molecular Imaging
2017;51(4):362-363
- CountryRepublic of Korea
- Language:English
-
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.
