Nucl Med Mol Imaging.
2017 Dec;51(4):362-363. 10.1007/s13139-016-0434-9.
Images from ¹â¸F-DOPA Scan in Congenital Hyperinsulinism: Not Always a Clue for Diagnosis
- Affiliations
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- 1Inherited 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
- 2Paediatric Surgery Unit, Department of Surgical Sciences, “Giambattista Rossi†Hospital, University of Verona, Verona, Italy.
- 3Department of Radiology, “Giambattista Rossi†Hospital, University of Verona, Verona, Italy.
- 4Department of Nuclear Medicine, Ospedale Sacro Cuore Don Calabria, Negrar, University of Verona, Verona, Italy.
- 5Division of Paediatric Endocrinology, Paediatric Clinic, Department of Life and Reproduction Sciences, “Giambattista Rossi†Hospital, University of Verona, Verona, Italy.
- KMID: 2403513
- DOI: http://doi.org/10.1007/s13139-016-0434-9
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). ¹â¸â»Fluoro-L-dihydroxy-phenylalanine (¹â¸F-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 ¹â¸F-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 ¹â¸F-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 ¹â¸F-DOPA PET/CT in children affected by CHI, suggesting that when ¹â¸F-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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