ESPE Abstracts (2015) 84 P-3-1069

Experience Based on 193 18F-DOPA PET CTs in Patients with Congenital Hyperinsulinism: Pearls and Pitfalls in Imaging Diagnostics in Patients with CHI

Peter Kühnena, Vikas Prasadb, Winfried Brennerb, Wolfgang Mohnikec & Oliver Blankensteina

aInstitute for Paediatric Endocrinology, Charité Universitätsmedizin Berlin, Berlin, Germany; bClinic of Nuclear Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany; cDTZ am Frankfurter Tor, Berlin, Germany

Background: In congenital hyperinsulinism (CHI) 18F-DOPA PET CT plays an essential role in differentiating between focal and diffuse CHI forms and in the analysis of the localization of a potential focus before surgery.

Objective and hypotheses: The aim of this retrospective analysis was the evaluation of the 18F-DOPA PET CT efficacy in a large cohort of CHI patients.

Method: In the last few years 193 18F-DOPA PET CTs were performed in our centre in CHI patients and we performed a retrospective analysis of specificity and sensitivity based on the results of the histological evaluation of the samples after surgery, clinical course of the patient and molecular genetic findings.

Results: With one exception it was possible in all cases with the 18F-DOPA PET CT to differentiate between focal and diffuse CHI forms in addition to molecular genetic results. However, in three cases the 18F-DOPA PET CT failed to visualize the complete expansion of the affected region and the giant spreading of the focus was identified during surgery. Finally, in three cases the CHI patients received in addition to the 18F-DOPA PET CT scan a DOTATOC PET CT. Thereby one focus was additionally identified, which would have been missed with the traditional approach using only the 18F-DOPA PET CT.

Conclusion: The imaging diagnostics is a critical step in the work up of patients with CHI. Being aware of the advantages and pitfalls of this method is an important step to improve the quality of the diagnostic and finally the therapeutic regime in patients with congenital hyperinsulinism.

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