Differential diagnosis of morphological forms of congenital hyperinsulinism using [18F]-DOPA PET/CT
https://doi.org/10.14341/probl9726
Abstract
Congenital hyperinsulinism (CHI) is caused by insulin hyperproduction by β-pancreatic cells. CHI is associated with high risk of complications of chronic hypoglycemia, and therefore timely diagnosis of the disease and immediate initiation of therapy is a top-priority task. The choice of treatment tactics largely depends on the morphological form of the disease. Morphological form cannot be established based on clinical and laboratory presentation of the disease, ultrasound, MRI, computed and positron emission tomography (PET) with [18F]-fluorodeoxyglucose. Calcium stimulation test and percutaneous transhepatic blood sampling from the portal vein were previously used for differential diagnosis, but the results provided by these invasive studies are imprecise. At present, preoperative differential diagnosis of diffuse and focal forms of CHI is based on the data of genetic testing and radionuclide diagnosis ([18F]-DOPA PET). The article presents the first results of the use of [18F]-DOPA PET in CHI patients in the Russian Federation. Radionuclide study was performed in 17 patients with pharmacoresistant CHI followed by comparative analysis of the results of 18F-FDG PET/CT and histological picture of intraoperative pancreatic tissue samples, which is known as the gold standard for the differential diagnosis of HI histological forms.
About the Authors
Diliara N. GubaevaEndocrinology Research Certre
Russian Federation
MD
Maria A. Melikyan
Endocrinology Research Certre
Russian Federation
MD, PhD, leading research associate
Daria V. Ryzhkova
Almazov National Medical Research Center
Russian Federation
MD, PhD, Professor
Lubov B. Mitrofanova
Almazov National Medical Research Center
Russian Federation
MD, PhD
Irina L. Nikitina
Almazov National Medical Research Center
Russian Federation
MD, PhD, Professor
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1. Fig. 1, a. Results of positron emission tomography with [18F] -Fluoro-DOPA: focal form of WGI. | |
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2. Fig. 1, b. Results of positron emission tomography with [18F] -fluorodof: diffuse form of WGI. | |
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For citations:
Gubaeva D.N., Melikyan M.A., Ryzhkova D.V., Mitrofanova L.B., Nikitina I.L. Differential diagnosis of morphological forms of congenital hyperinsulinism using [18F]-DOPA PET/CT. Problems of Endocrinology. 2018;64(5):306-311. https://doi.org/10.14341/probl9726
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