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{sup 18}F-FDOPA PET/CT imaging of insulinoma revisited

Abstract

{sup 18}F-FDOPA PET imaging is increasingly used in the work-up of patients with neuroendocrine tumours. It has been shown to be of limited value in localizing pancreatic insulin-secreting tumours in adults with hyperinsulinaemic hypoglycaemia (HH) mainly due to {sup 18}F-FDOPA uptake by the whole pancreatic gland. The objective of this study was to review our experience with {sup 18}F-FDOPA PET/CT imaging with carbidopa (CD) premedication in patients with HH in comparison with PET/CT studies performed without CD premedication in an independent population. A retrospective study including 16 HH patients who were investigated between January 2011 and December 2013 using {sup 18}F-FDOPA PET/CT (17 examinations) in two academic endocrine tumour centres was conducted. All PET/CT examinations were performed under CD premedication (200 mg orally, 1 - 2 h prior to tracer injection). The PET/CT acquisition protocol included an early acquisition (5 min after {sup 18}F-FDOPA injection) centred over the upper abdomen and a delayed whole-body acquisition starting 20 - 30 min later. An independent series of eight consecutive patients with HH and investigated before 2011 were considered for comparison. All patients had a reference whole-body PET/CT scan performed about 1 h after {sup 18}F-FDOPA injection. In all cases, PET/CT was performed  More>>
Authors:
Imperiale, Alessio; Namer, Izzie-Jacques; [1]  University of Strasbourg/CNRS and FMTS, Faculty of Medicine, ICube - UMR 7357, Strasbourg (France)]; Sebag, Frederic; [2]  Vix, Michel; [3]  Castinetti, Frederic; [4]  Kessler, Laurence; Moreau, Francois; [5]  Bachellier, Philippe; [6]  Guillet, Benjamin; Mundler, Olivier; [7]  Taieb, David; [7]  Aix-Marseille University, Biophysics and Nuclear Medecine, La Timone University Hospital, European Center for Research in Medical Imaging, Marseille (France)]
  1. University Hospitals of Strasbourg, Department of Biophysics and Nuclear Medicine, Strasbourg (France)
  2. Aix-Marseille University, Department of Endocrine Surgery, La Timone University Hospital, Marseille (France)
  3. University of Strasbourg, Department of General, Digestive, and Endocrine Surgery, IRCAD-IHU, Strasbourg (France)
  4. Aix-Marseille University, Department of Endocrinology, Diabetes and Metabolic Disorders, La Timone University Hospital, Marseille (France)
  5. University of Strasbourg, Department of Diabetology, University Hospital of Strasbourg, Strasbourg (France)
  6. University Hospitals of Strasbourg, Department of Visceral Surgery and Transplantation, Strasbourg (France)
  7. Aix-Marseille University, Department of Nuclear Medicine, La Timone University Hospital, CERIMED, Marseille (France)
Publication Date:
Nov 01, 2014
Product Type:
Journal Article
Resource Relation:
Journal Name: European Journal of Nuclear Medicine and Molecular Imaging; Journal Volume: 42; Journal Issue: 3
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ABDOMEN; COMPUTERIZED TOMOGRAPHY; CONTRAST MEDIA; DIAGNOSIS; DOPA; ENDOCRINE DISEASES; ENDOCRINE GLANDS; FLUORINE 18; GLUCOSE; INSULIN; NEOPLASMS; PANCREAS; POSITRON COMPUTED TOMOGRAPHY; RADIOPHARMACEUTICALS; TRACER TECHNIQUES; UPTAKE
OSTI ID:
22335574
Country of Origin:
Germany
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 1619-7070; TRN: DE15F1720041868
Availability:
Available from: http://dx.doi.org/10.1007/s00259-014-2943-z
Submitting Site:
DE
Size:
page(s) 409-418
Announcement Date:
May 14, 2015

Citation Formats

Imperiale, Alessio, Namer, Izzie-Jacques, University of Strasbourg/CNRS and FMTS, Faculty of Medicine, ICube - UMR 7357, Strasbourg (France)], Sebag, Frederic, Vix, Michel, Castinetti, Frederic, Kessler, Laurence, Moreau, Francois, Bachellier, Philippe, Guillet, Benjamin, Mundler, Olivier, Taieb, David, and Aix-Marseille University, Biophysics and Nuclear Medecine, La Timone University Hospital, European Center for Research in Medical Imaging, Marseille (France)]. {sup 18}F-FDOPA PET/CT imaging of insulinoma revisited. Germany: N. p., 2014. Web. doi:10.1007/S00259-014-2943-Z.
Imperiale, Alessio, Namer, Izzie-Jacques, University of Strasbourg/CNRS and FMTS, Faculty of Medicine, ICube - UMR 7357, Strasbourg (France)], Sebag, Frederic, Vix, Michel, Castinetti, Frederic, Kessler, Laurence, Moreau, Francois, Bachellier, Philippe, Guillet, Benjamin, Mundler, Olivier, Taieb, David, & Aix-Marseille University, Biophysics and Nuclear Medecine, La Timone University Hospital, European Center for Research in Medical Imaging, Marseille (France)]. {sup 18}F-FDOPA PET/CT imaging of insulinoma revisited. Germany. https://doi.org/10.1007/S00259-014-2943-Z
Imperiale, Alessio, Namer, Izzie-Jacques, University of Strasbourg/CNRS and FMTS, Faculty of Medicine, ICube - UMR 7357, Strasbourg (France)], Sebag, Frederic, Vix, Michel, Castinetti, Frederic, Kessler, Laurence, Moreau, Francois, Bachellier, Philippe, Guillet, Benjamin, Mundler, Olivier, Taieb, David, and Aix-Marseille University, Biophysics and Nuclear Medecine, La Timone University Hospital, European Center for Research in Medical Imaging, Marseille (France)]. 2014. "{sup 18}F-FDOPA PET/CT imaging of insulinoma revisited." Germany. https://doi.org/10.1007/S00259-014-2943-Z.
@misc{etde_22335574,
title = {{sup 18}F-FDOPA PET/CT imaging of insulinoma revisited}
author = {Imperiale, Alessio, Namer, Izzie-Jacques, University of Strasbourg/CNRS and FMTS, Faculty of Medicine, ICube - UMR 7357, Strasbourg (France)], Sebag, Frederic, Vix, Michel, Castinetti, Frederic, Kessler, Laurence, Moreau, Francois, Bachellier, Philippe, Guillet, Benjamin, Mundler, Olivier, Taieb, David, and Aix-Marseille University, Biophysics and Nuclear Medecine, La Timone University Hospital, European Center for Research in Medical Imaging, Marseille (France)]}
abstractNote = {{sup 18}F-FDOPA PET imaging is increasingly used in the work-up of patients with neuroendocrine tumours. It has been shown to be of limited value in localizing pancreatic insulin-secreting tumours in adults with hyperinsulinaemic hypoglycaemia (HH) mainly due to {sup 18}F-FDOPA uptake by the whole pancreatic gland. The objective of this study was to review our experience with {sup 18}F-FDOPA PET/CT imaging with carbidopa (CD) premedication in patients with HH in comparison with PET/CT studies performed without CD premedication in an independent population. A retrospective study including 16 HH patients who were investigated between January 2011 and December 2013 using {sup 18}F-FDOPA PET/CT (17 examinations) in two academic endocrine tumour centres was conducted. All PET/CT examinations were performed under CD premedication (200 mg orally, 1 - 2 h prior to tracer injection). The PET/CT acquisition protocol included an early acquisition (5 min after {sup 18}F-FDOPA injection) centred over the upper abdomen and a delayed whole-body acquisition starting 20 - 30 min later. An independent series of eight consecutive patients with HH and investigated before 2011 were considered for comparison. All patients had a reference whole-body PET/CT scan performed about 1 h after {sup 18}F-FDOPA injection. In all cases, PET/CT was performed without CD premedication. In the study group, {sup 18}F-FDOPA PET/CT with CD premedication was positive in 8 out of 11 patients with histologically proven insulinoma (73 %). All {sup 18}F-FDOPA PET/CT-avid insulinomas were detected on early images and 5 of 11 (45 %) on delayed ones. The tumour/normal pancreas uptake ratio was not significantly different between early and delayed acquisitions. Considering all patients with HH, including those without imaging evidence of disease, the detection rate of the primary lesions using CD-assisted {sup 18}F-FDOPA PET/CT was 53 %, showing 9 insulinomas in 17 studies performed. In the control group (without CD premedication, eight patients), the final diagnosis was benign insulinoma in four, nesidioblastosis in one, and no definitive diagnosis in the remainder. {sup 18}F-FDOPA PET/CT failed to detect any tumour in these patients. According to our experience, CD administration before {sup 18}F-FDOPA injection leads to low residual pancreatic {sup 18}F-FDOPA activity preserving tumoral uptake with consequent insulinoma detection in more than half of adult patients with HH and more than 70 % of patients with a final diagnosis of insulinoma. If {sup 18}F-FDOPA PET/CT is indicated, we strongly recommend combining CD premedication with early acquisition centred over the pancreas. (orig.)}
doi = {10.1007/S00259-014-2943-Z}
journal = []
issue = {3}
volume = {42}
journal type = {AC}
place = {Germany}
year = {2014}
month = {Nov}
}