BSPED2013 Poster Presentations (1) (89 abstracts)
18F-DOPA PET MRI as a new imaging modality for the precise localisation of focal congenital hyperinsulinism
Senthil Senniappan 1 , Pratik Shah 1 , Marguerite du Preez 2 , Raymond Endozo 2 , Celia O’Meara 2 , Caroline Townsend 2 , Clare Gilbert 1 , Kate Morgan 1 , Louise Hinchey 1 , Agostino Pierro 1 , Lorenzo Biassoni 1 , Oystein Olsen 1 , Jamshed Bomanji 2 & Khalid Hussain 1
1Great Ormond Street Hospital, London, UK; 2University College London Hospital, London, UK.
Introduction: Congenital hyperinsulinism (CHI) includes two major histological subtypes; diffuse and focal. Fluorine-18-L dihydroxyphenylalanine positron emission tomography (18F-DOPA PET/CT) has been established as a novel imagining technique to differentiate focal from diffuse CHI. However CT provides only limited soft tissue contrast and exposes the patient to a significant radiation dose. PET/MRI could provide images with an excellent soft tissue contrast, very good spatial resolution of the anatomy and very accurate temporal and spatial image fusion with no additional radiation exposure. We aimed to evaluate the feasibility of using 18F-DOPA PET/MRI for the diagnosis focal CHI.
Methods: Five children with severe CHI underwent simultaneous 18F-DOPA PET/CT and PET/MRI imaging. All medications including octreotide and glucagon were discontinued 48 h before the scan. The 18F-DOPA was administered intravenously at a dose of 4 MBq/kg and iodine contrast media at a dosage of 1.5 ml/kg. Three regions of interest were drawn in the head, body, and tail of the pancreas to calculate the standardized uptake values (SUV max).
Results: PET/MRI in 4 children revealed diffuse CHI (SUV<1.3) and one child had focal CHI (SUV>1.5). The focal lesion was delineated clearly in accordance with the results from PET/CT images. In addition PET/MRI provided soft tissue and anatomical information of the adjacent structures that aided the precise surgical resection of the lesion.
Conclusions: In this preliminary study, we have demonstrated the feasibility of using PET/MRI as a novel imaging modality for diagnosing focal CHI. Further studies are needed to establish the accuracy and validity of PET/MRI. Given the potential of less radiation exposure and higher soft tissue clarity, PET/MRI is likely to become a preferred imaging modality for CHI management.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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