Role of Ga somatostatin receptor PET/CT in the detection of endogenous hyperinsulinaemic focus: an explorative study.
Purpose: To explore the role of Ga-DOTATATE/DOTATOC PET/CT (SR PET/CT) in patients with suspicion of or histopathologically proven pancreatogenic hyperinsulinaemic hypoglycaemia. Methods: We included 13 patients with histopathologically proven or a high clinical suspicion of pancreatogenic hyperinsu...
| Publicado en: | European Journal of Nuclear Medicine & Molecular Imaging Vol. 43; no. 9; pp. 1593 - 1601 |
|---|---|
| Autores principales: | , , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Aug2016
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=116622150&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 116622150 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 16197070 NPC jtl: European Journal of Nuclear Medicine & Molecular Imaging issn: 16197070 maglogo: N pubinfo: dt: Aug2016 vid: 43 iid: 9 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 116622150 10.1007/s00259-016-3331-7 116622150 ppf: 1593 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Role of Ga somatostatin receptor PET/CT in the detection of endogenous hyperinsulinaemic focus: an explorative study. aug: au: Prasad, Vikas Sainz-Esteban, Aurora Arsenic, Ruza Plöckinger, Ursula Denecke, Timm Pape, Ulrich-Frank Pascher, Andreas Kühnen, Peter Pavel, Marianne Blankenstein, Oliver affil: Department of Nuclear Medicine, Charité Universitätsmedizin Berlin, Berlin Germany sug: ab: Purpose: To explore the role of Ga-DOTATATE/DOTATOC PET/CT (SR PET/CT) in patients with suspicion of or histopathologically proven pancreatogenic hyperinsulinaemic hypoglycaemia. Methods: We included 13 patients with histopathologically proven or a high clinical suspicion of pancreatogenic hyperinsulinaemia. All the patients underwent a SR PET/CT scan. The results were correlated with histopathological findings. Normalization of blood glucose levels after resection of the pancreatic lesion, as well as a cytological and/or pathological diagnosis of insulinoma, was considered the diagnostic gold standard for insulinoma. The diagnosis of nesidioblastosis was based on exclusion of an insulinoma and conclusive pathological examination of a segment of the pancreas. Malignant insulinoma was defined as the presence of locoregional or distant metastases. Results: Based on histopathology, 13 patients were found to have pancreatic hyperinsulinaemia: two patients had malignant insulinoma, eight had nonmetastasized insulinoma, and three had nesidioblastosis. SR PET was positive in 11 of the 13 patients (84.6 %) with a final diagnosis of endogenous pancreatic hypoglycaemia. Histopathological staining confirmed 16 foci of hyperinsulinism (insulin positivity). SR PET detected 14 of the 16 lesions, resulting in a sensitivity of 87 %. One intrapancreatic spleen was falsely diagnosed as insulinoma focus on SR PET, resulting in positive predictive value of 93.3 %. Immunohistochemical staining of somatostatin receptor (SSR) subtype 2a was available in ten specimens: two nesidioblastosis, and seven benign and one malignant insulinoma. Eight out of the ten specimens (80 %) stained strongly to moderately positive. Seven of the eight SSR2a-positive lesions were picked up on SR PET. Based on the results of SR PET/CT, nine patients achieved complete remission of the hypoglycaemic events during follow-up. Conclusion: This explorative study suggests that SR PET in combination with CT may play a significant role in the detection and management of patients with pancreatogenic hyperinsulinaemic hypoglycaemia. A large proportion of insulinomas express SSR2a, and a larger study is needed to fully assess the diagnostic accuracy of SR PET in patients with insulinoma and nesidioblastosis compared with current localizing studies used in clinical practice. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|