PET Detects Pancreas Defects in Newborns Very Accurately

When the disease is confined to a limited section of the baby's pancreas, the PET scan is 100% accurate in finding the abnormal spot, and guiding surgeons to curative, organ-sparing surgery.

Investigators from the Children's Hospital of Philadelphia (PA, USA) and the University of Pennsylvania School of Medicine (Philadelphia, PA, USA) reported highly promising initial findings from a study of 24 infants referred to the Hyperinsulinism Center at the Children's Hospital between December 2004 and November 2005. All the children had congenital HI that could not be controlled with medicine. If this condition goes uncontrolled, abnormally high insulin levels may cause irreversible brain damage. The study was published in the February 2007 issue of the Journal of Pediatrics.

Congenital HI is caused by mutations that damage the insulin-secreting beta cells in the pancreas, which in an infant is smaller than an adult's little finger. When the abnormal cells are limited to a discrete portion of the pancreas, the disease is focal; when the abnormal cells are distributed throughout the organ, the disease is diffuse. Accurate diagnosis is important because focal disease can be cured by surgically removing the focal lesions. In diffuse disease, surgeons may remove nearly the entire pancreas, but that leaves the child at risk for later diabetes.

Using a mildly radioactive compound called 18F-fluoro-L-dihydroxyphenylalanine, or [18F]-DOPA, the researchers detected focal or diffuse hyperinsulinism accurately in 23 of the 24 cases, an accuracy of 96%. In the 11 cases with focal hyperinsulinism, the technique was 100% accurate in targeting the abnormal lesions. [18F]-DOPA binds to the lesions, which then are visible to the naked eye on a body scanner.

"When we compared our findings from the PET scan with pathological results, we found 100% agreement in locating the focal lesions,” said Olga T. Hardy, M.D., a pediatric endocrinologist at Children's Hospital who was the study's lead investigator. "This accuracy is superior to that of invasive, technically difficult techniques that measure insulin sampled from specific veins in an infant.”




Related Links:
Children's Hospital of Philadelphia
University of Pennsylvania School of Medicine