AI Article Synopsis
- Focal congenital hyperinsulinism (CHI) can be cured through surgery, making the identification of the focal lesion critical. This study compares the diagnostic effectiveness of 18F-DOPA PET/CT and 68Ga-DOTANOC PET/CT for detecting focal CHI.
- The research involved retrospective evaluations of PET/CT scans from CHI patients, using histology and genetic profiles as reference standards, revealing that 18F-DOPA PET/CT had a significantly higher predictive accuracy than 68Ga-DOTANOC PET/CT.
- The findings indicate that 18F-DOPA PET/CT is highly effective in identifying focal CHI, with accuracy in lesion localization, whereas the use of 68Ga-DOT
Article Abstract
Purpose: Focal congenital hyperinsulinism (CHI) is curable by surgery, which is why identification of the focal lesion is crucial. We aimed to determine the use of 18F-fluoro-dihydroxyphenylalanine (18F-DOPA) PET/CT vs. 68Ga-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic-acid-1-Nal3-octreotide (68Ga-DOTANOC) PET/CT as diagnostic tools in focal CHI.
Methods: PET/CT scans of children with CHI admitted to Odense University Hospital between August 2005 and June 2016 were retrospectively evaluated visually and by their maximal standardized uptake values (SUV) by two independent examiners, blinded for clinical, surgical and pathological data. Pancreatic histology was used as the gold standard. For patients without surgery, the genetic profile served as the gold standard.
Results: Fifty-five CHI patients were examined by PET/CT (18F-DOPA n = 53, 68Ga-DOTANOC n = 18). Surgery was performed in 34 patients, no surgery in 21 patients. Fifty-one patients had a classifiable outcome, either by histology (n = 33, 22 focal lesions, 11 non-focal) or by genetics (n = 18, all non-focal). The predictive performance of 18F-DOPA PET/CT to identify focal CHI was identical by visual- and cut-off-based evaluation: sensitivity (95% CI) of 1 (0.85-1); specificity of 0.96 (0.82-0.99). The optimal 18F-DOPA PET SUV ratio cut-off was 1.44 and the optimal 68Ga-DOTANOC PET SUV cut-off was 6.77 g/ml. The area under the receiver operating curve was 0.98 (0.93-1) for 18F-DOPA PET vs. 0.71 (0.43-0.95) for 68Ga-DOTANOC PET (p < 0.03). In patients subjected to surgery, localization of the focal lesion was correct in 91%, and 100%, by 18F-DOPA PET/CT and 68Ga-DOTANOC PET/CT, respectively.
Conclusion: 18F-DOPA PET/CT was excellent in predicting focal CHI and superior compared to 68Ga-DOTANOC PET/CT. Further use of 68GA-DOTANOC PET/CT in predicting focal CHI is discouraged.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5745571 | PMC |
| http://dx.doi.org/10.1007/s00259-017-3867-1 | DOI Listing |
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