Limited Value of 18F-F-DOPA PET to Localize Pancreatic Insulin-Secreting Tumors in Adults with Hyperinsulinemic Hypoglycemia
Context: Fluorine-18-l-dihydroxyphenylalanine positron emission tomography (18F-FDOPA PET) imaging is increasingly used in the workup of neuroendocrine tumors. It has been shown to be an accurate tool in the diagnosis of congenital hyperinsulinism, but limited information is available on its value i...
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| creator | Tessonnier, L Sebag, F Ghander, C De Micco, C Reynaud, R Palazzo, F. F Conte-Devolx, B Henry, J. F Mundler, O Taïeb, D |
| description | Context: Fluorine-18-l-dihydroxyphenylalanine positron emission tomography (18F-FDOPA PET) imaging is increasingly used in the workup of neuroendocrine tumors. It has been shown to be an accurate tool in the diagnosis of congenital hyperinsulinism, but limited information is available on its value in adult disease.
Objective, Patients, and Design: The objective of this study was to review our experience with 18F-FDOPA PET imaging in six consecutive patients with hyperinsulinemic hypoglycemia (HH) (four solitary insulinomas, one diffuse β-cell hyperplasia, one malignant insulinoma). 18F-FDOPA uptake was also evaluated in 37 patients (43 procedures) without HH or other pancreatic neuroendocrine tumors, which acted as a control group.
Results: Using visual analysis, 18F-FDOPA-PET proved positive in only one case (a multiple endocrine neoplasia type 1 related insulinoma). In diffuse β-cell hyperplasia, the pancreatic uptake was similar to controls. In the patient with liver metastases, the extent of disease was underestimated. The pancreatic uptake was not statistically different between controls and hyperinsulinemic patients. The main limitation for identifying insulinomas or β-cell hyperplasia in adults appears to be to the 18F-FDOPA uptake and retention in the whole pancreas. This drawback is potentially circumvented in focal hyperplasia in newborns due to a lower aromatic amino acid decarboxylase expression in the extralesional pancreatic parenchyma.
Conclusions: 18F-FDOPA PET is of limited value in localizing pancreatic insulin secreting tumors in adult HH. Our results contrast with the referential study and require further analysis.
The limited value of 18F-FDOPA PET for tumor localization in adults with hyperinsulinemic hypoglycemia is mainly due to high tracer uptake and retention in the whole pancreas. |
| doi_str_mv | 10.1210/jc.2009-1357 |
| format | Article |
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Objective, Patients, and Design: The objective of this study was to review our experience with 18F-FDOPA PET imaging in six consecutive patients with hyperinsulinemic hypoglycemia (HH) (four solitary insulinomas, one diffuse β-cell hyperplasia, one malignant insulinoma). 18F-FDOPA uptake was also evaluated in 37 patients (43 procedures) without HH or other pancreatic neuroendocrine tumors, which acted as a control group.
Results: Using visual analysis, 18F-FDOPA-PET proved positive in only one case (a multiple endocrine neoplasia type 1 related insulinoma). In diffuse β-cell hyperplasia, the pancreatic uptake was similar to controls. In the patient with liver metastases, the extent of disease was underestimated. The pancreatic uptake was not statistically different between controls and hyperinsulinemic patients. The main limitation for identifying insulinomas or β-cell hyperplasia in adults appears to be to the 18F-FDOPA uptake and retention in the whole pancreas. This drawback is potentially circumvented in focal hyperplasia in newborns due to a lower aromatic amino acid decarboxylase expression in the extralesional pancreatic parenchyma.
Conclusions: 18F-FDOPA PET is of limited value in localizing pancreatic insulin secreting tumors in adult HH. Our results contrast with the referential study and require further analysis.
The limited value of 18F-FDOPA PET for tumor localization in adults with hyperinsulinemic hypoglycemia is mainly due to high tracer uptake and retention in the whole pancreas.</description><identifier>ISSN: 0021-972X</identifier><identifier>EISSN: 1945-7197</identifier><identifier>DOI: 10.1210/jc.2009-1357</identifier><identifier>PMID: 19915018</identifier><identifier>CODEN: JCEMAZ</identifier><language>eng</language><publisher>Bethesda, MD: Endocrine Society</publisher><subject>Adolescent ; Adult ; Adults ; Aged ; Amino acids ; Beta cells ; Biological and medical sciences ; Child ; Dihydroxyphenylalanine ; Dihydroxyphenylalanine - analogs & derivatives ; Endocrinopathies ; Feeding. Feeding behavior ; Female ; Fundamental and applied biological sciences. Psychology ; Hepatocytes ; Humans ; Hyperinsulinism - complications ; Hyperinsulinism - diagnostic imaging ; Hyperplasia ; Hypoglycemia ; Hypoglycemia - complications ; Hypoglycemia - diagnostic imaging ; Insulin ; Insulin-Secreting Cells - diagnostic imaging ; Insulin-Secreting Cells - pathology ; Insulinoma ; Insulinoma - complications ; Insulinoma - diagnostic imaging ; Liver diseases ; Male ; Medical sciences ; Metastases ; Middle Aged ; Multiple endocrine neoplasia ; Neonates ; Neuroendocrine tumors ; Pancreas ; Pancreatic Neoplasms - complications ; Pancreatic Neoplasms - diagnostic imaging ; Parenchyma ; Positron emission tomography ; Positron-Emission Tomography - methods ; Predictive Value of Tests ; Retrospective Studies ; Vertebrates: anatomy and physiology, studies on body, several organs or systems ; Vertebrates: endocrinology ; Young Adult</subject><ispartof>The journal of clinical endocrinology and metabolism, 2010-01, Vol.95 (1), p.303-307</ispartof><rights>Copyright © 2010 by The Endocrine Society 2010</rights><rights>Copyright © 2010 by The Endocrine Society</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5075-b7a7b686f8d1fc0b982ad5395c3bc84d26fd1fc9c8401f2f2d113dcbc5e144c13</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,4010,27900,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22333297$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19915018$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tessonnier, L</creatorcontrib><creatorcontrib>Sebag, F</creatorcontrib><creatorcontrib>Ghander, C</creatorcontrib><creatorcontrib>De Micco, C</creatorcontrib><creatorcontrib>Reynaud, R</creatorcontrib><creatorcontrib>Palazzo, F. F</creatorcontrib><creatorcontrib>Conte-Devolx, B</creatorcontrib><creatorcontrib>Henry, J. F</creatorcontrib><creatorcontrib>Mundler, O</creatorcontrib><creatorcontrib>Taïeb, D</creatorcontrib><title>Limited Value of 18F-F-DOPA PET to Localize Pancreatic Insulin-Secreting Tumors in Adults with Hyperinsulinemic Hypoglycemia</title><title>The journal of clinical endocrinology and metabolism</title><addtitle>J Clin Endocrinol Metab</addtitle><description>Context: Fluorine-18-l-dihydroxyphenylalanine positron emission tomography (18F-FDOPA PET) imaging is increasingly used in the workup of neuroendocrine tumors. It has been shown to be an accurate tool in the diagnosis of congenital hyperinsulinism, but limited information is available on its value in adult disease.
Objective, Patients, and Design: The objective of this study was to review our experience with 18F-FDOPA PET imaging in six consecutive patients with hyperinsulinemic hypoglycemia (HH) (four solitary insulinomas, one diffuse β-cell hyperplasia, one malignant insulinoma). 18F-FDOPA uptake was also evaluated in 37 patients (43 procedures) without HH or other pancreatic neuroendocrine tumors, which acted as a control group.
Results: Using visual analysis, 18F-FDOPA-PET proved positive in only one case (a multiple endocrine neoplasia type 1 related insulinoma). In diffuse β-cell hyperplasia, the pancreatic uptake was similar to controls. In the patient with liver metastases, the extent of disease was underestimated. The pancreatic uptake was not statistically different between controls and hyperinsulinemic patients. The main limitation for identifying insulinomas or β-cell hyperplasia in adults appears to be to the 18F-FDOPA uptake and retention in the whole pancreas. This drawback is potentially circumvented in focal hyperplasia in newborns due to a lower aromatic amino acid decarboxylase expression in the extralesional pancreatic parenchyma.
Conclusions: 18F-FDOPA PET is of limited value in localizing pancreatic insulin secreting tumors in adult HH. Our results contrast with the referential study and require further analysis.
The limited value of 18F-FDOPA PET for tumor localization in adults with hyperinsulinemic hypoglycemia is mainly due to high tracer uptake and retention in the whole pancreas.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Adults</subject><subject>Aged</subject><subject>Amino acids</subject><subject>Beta cells</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Dihydroxyphenylalanine</subject><subject>Dihydroxyphenylalanine - analogs & derivatives</subject><subject>Endocrinopathies</subject><subject>Feeding. Feeding behavior</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Hepatocytes</subject><subject>Humans</subject><subject>Hyperinsulinism - complications</subject><subject>Hyperinsulinism - diagnostic imaging</subject><subject>Hyperplasia</subject><subject>Hypoglycemia</subject><subject>Hypoglycemia - complications</subject><subject>Hypoglycemia - diagnostic imaging</subject><subject>Insulin</subject><subject>Insulin-Secreting Cells - diagnostic imaging</subject><subject>Insulin-Secreting Cells - pathology</subject><subject>Insulinoma</subject><subject>Insulinoma - complications</subject><subject>Insulinoma - diagnostic imaging</subject><subject>Liver diseases</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metastases</subject><subject>Middle Aged</subject><subject>Multiple endocrine neoplasia</subject><subject>Neonates</subject><subject>Neuroendocrine tumors</subject><subject>Pancreas</subject><subject>Pancreatic Neoplasms - complications</subject><subject>Pancreatic Neoplasms - diagnostic imaging</subject><subject>Parenchyma</subject><subject>Positron emission tomography</subject><subject>Positron-Emission Tomography - methods</subject><subject>Predictive Value of Tests</subject><subject>Retrospective Studies</subject><subject>Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><subject>Vertebrates: endocrinology</subject><subject>Young Adult</subject><issn>0021-972X</issn><issn>1945-7197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kdGLEzEQxhdRvHr65rMERHwxZybZNLuP5bx6B4UrWMW3kM1mr6nZTS_ZpVT8482yxYJoCCSZ_GaYb74sew3kCiiQjzt9RQkpMTAunmQzKHOOBZTiaTYjhAIuBf1-kb2IcUcI5Dlnz7MLKEvgBIpZ9mtlW9ubGn1TbjDINwiKJV7iT_frBVrfbFDv0cpr5exPg9aq08Go3mp018XB2Q5_MSnS2-4BbYbWh4hshxb14PqIDrbfotvj3gQ7waZNiSngH9xRp4d6mT1rlIvm1em8zL4ubzbXt3h1__nuerHCmhPBcSWUqObFvClqaDSpyoKqmrOSa1bpIq_pvBk_ynQn0NCG1gCs1pXmJgnWwC6z91PdffCPg4m9bG3UxjnVGT9EKVhOGeEgEvn2L3Lnh9Cl5iSDeZ4zJgRN1IeJ0sHHGEwj98G2KhwlEDmaIndajqbI0ZSEvzkVHarW1Gf45EIC3p0AFdOom5DmbOMfjlLGGC3HQvnEHbzrTYg_3HAwQW6Ncv1WkrTyuSgwJUDGTfAY4Wf5ftj_r1N86pRNpOlqr5NvZh9MjOch_FPfb7apwGs</recordid><startdate>201001</startdate><enddate>201001</enddate><creator>Tessonnier, L</creator><creator>Sebag, F</creator><creator>Ghander, C</creator><creator>De Micco, C</creator><creator>Reynaud, R</creator><creator>Palazzo, F. F</creator><creator>Conte-Devolx, B</creator><creator>Henry, J. F</creator><creator>Mundler, O</creator><creator>Taïeb, D</creator><general>Endocrine Society</general><general>Oxford University Press</general><general>Copyright by The Endocrine Society</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T5</scope><scope>7TM</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201001</creationdate><title>Limited Value of 18F-F-DOPA PET to Localize Pancreatic Insulin-Secreting Tumors in Adults with Hyperinsulinemic Hypoglycemia</title><author>Tessonnier, L ; Sebag, F ; Ghander, C ; De Micco, C ; Reynaud, R ; Palazzo, F. F ; Conte-Devolx, B ; Henry, J. F ; Mundler, O ; Taïeb, D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5075-b7a7b686f8d1fc0b982ad5395c3bc84d26fd1fc9c8401f2f2d113dcbc5e144c13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Adults</topic><topic>Aged</topic><topic>Amino acids</topic><topic>Beta cells</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Dihydroxyphenylalanine</topic><topic>Dihydroxyphenylalanine - analogs & derivatives</topic><topic>Endocrinopathies</topic><topic>Feeding. Feeding behavior</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Hepatocytes</topic><topic>Humans</topic><topic>Hyperinsulinism - complications</topic><topic>Hyperinsulinism - diagnostic imaging</topic><topic>Hyperplasia</topic><topic>Hypoglycemia</topic><topic>Hypoglycemia - complications</topic><topic>Hypoglycemia - diagnostic imaging</topic><topic>Insulin</topic><topic>Insulin-Secreting Cells - diagnostic imaging</topic><topic>Insulin-Secreting Cells - pathology</topic><topic>Insulinoma</topic><topic>Insulinoma - complications</topic><topic>Insulinoma - diagnostic imaging</topic><topic>Liver diseases</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metastases</topic><topic>Middle Aged</topic><topic>Multiple endocrine neoplasia</topic><topic>Neonates</topic><topic>Neuroendocrine tumors</topic><topic>Pancreas</topic><topic>Pancreatic Neoplasms - complications</topic><topic>Pancreatic Neoplasms - diagnostic imaging</topic><topic>Parenchyma</topic><topic>Positron emission tomography</topic><topic>Positron-Emission Tomography - methods</topic><topic>Predictive Value of Tests</topic><topic>Retrospective Studies</topic><topic>Vertebrates: anatomy and physiology, studies on body, several organs or systems</topic><topic>Vertebrates: endocrinology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tessonnier, L</creatorcontrib><creatorcontrib>Sebag, F</creatorcontrib><creatorcontrib>Ghander, C</creatorcontrib><creatorcontrib>De Micco, C</creatorcontrib><creatorcontrib>Reynaud, R</creatorcontrib><creatorcontrib>Palazzo, F. F</creatorcontrib><creatorcontrib>Conte-Devolx, B</creatorcontrib><creatorcontrib>Henry, J. F</creatorcontrib><creatorcontrib>Mundler, O</creatorcontrib><creatorcontrib>Taïeb, D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of clinical endocrinology and metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tessonnier, L</au><au>Sebag, F</au><au>Ghander, C</au><au>De Micco, C</au><au>Reynaud, R</au><au>Palazzo, F. F</au><au>Conte-Devolx, B</au><au>Henry, J. F</au><au>Mundler, O</au><au>Taïeb, D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Limited Value of 18F-F-DOPA PET to Localize Pancreatic Insulin-Secreting Tumors in Adults with Hyperinsulinemic Hypoglycemia</atitle><jtitle>The journal of clinical endocrinology and metabolism</jtitle><addtitle>J Clin Endocrinol Metab</addtitle><date>2010-01</date><risdate>2010</risdate><volume>95</volume><issue>1</issue><spage>303</spage><epage>307</epage><pages>303-307</pages><issn>0021-972X</issn><eissn>1945-7197</eissn><coden>JCEMAZ</coden><abstract>Context: Fluorine-18-l-dihydroxyphenylalanine positron emission tomography (18F-FDOPA PET) imaging is increasingly used in the workup of neuroendocrine tumors. It has been shown to be an accurate tool in the diagnosis of congenital hyperinsulinism, but limited information is available on its value in adult disease.
Objective, Patients, and Design: The objective of this study was to review our experience with 18F-FDOPA PET imaging in six consecutive patients with hyperinsulinemic hypoglycemia (HH) (four solitary insulinomas, one diffuse β-cell hyperplasia, one malignant insulinoma). 18F-FDOPA uptake was also evaluated in 37 patients (43 procedures) without HH or other pancreatic neuroendocrine tumors, which acted as a control group.
Results: Using visual analysis, 18F-FDOPA-PET proved positive in only one case (a multiple endocrine neoplasia type 1 related insulinoma). In diffuse β-cell hyperplasia, the pancreatic uptake was similar to controls. In the patient with liver metastases, the extent of disease was underestimated. The pancreatic uptake was not statistically different between controls and hyperinsulinemic patients. The main limitation for identifying insulinomas or β-cell hyperplasia in adults appears to be to the 18F-FDOPA uptake and retention in the whole pancreas. This drawback is potentially circumvented in focal hyperplasia in newborns due to a lower aromatic amino acid decarboxylase expression in the extralesional pancreatic parenchyma.
Conclusions: 18F-FDOPA PET is of limited value in localizing pancreatic insulin secreting tumors in adult HH. Our results contrast with the referential study and require further analysis.
The limited value of 18F-FDOPA PET for tumor localization in adults with hyperinsulinemic hypoglycemia is mainly due to high tracer uptake and retention in the whole pancreas.</abstract><cop>Bethesda, MD</cop><pub>Endocrine Society</pub><pmid>19915018</pmid><doi>10.1210/jc.2009-1357</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | The journal of clinical endocrinology and metabolism, 2010-01, Vol.95 (1), p.303-307 |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adolescent Adult Adults Aged Amino acids Beta cells Biological and medical sciences Child Dihydroxyphenylalanine Dihydroxyphenylalanine - analogs & derivatives Endocrinopathies Feeding. Feeding behavior Female Fundamental and applied biological sciences. Psychology Hepatocytes Humans Hyperinsulinism - complications Hyperinsulinism - diagnostic imaging Hyperplasia Hypoglycemia Hypoglycemia - complications Hypoglycemia - diagnostic imaging Insulin Insulin-Secreting Cells - diagnostic imaging Insulin-Secreting Cells - pathology Insulinoma Insulinoma - complications Insulinoma - diagnostic imaging Liver diseases Male Medical sciences Metastases Middle Aged Multiple endocrine neoplasia Neonates Neuroendocrine tumors Pancreas Pancreatic Neoplasms - complications Pancreatic Neoplasms - diagnostic imaging Parenchyma Positron emission tomography Positron-Emission Tomography - methods Predictive Value of Tests Retrospective Studies Vertebrates: anatomy and physiology, studies on body, several organs or systems Vertebrates: endocrinology Young Adult |
| title | Limited Value of 18F-F-DOPA PET to Localize Pancreatic Insulin-Secreting Tumors in Adults with Hyperinsulinemic Hypoglycemia |
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