Department of Pediatrics, Kizawa Memorial Hospital, Chubu Medical Center for Prolonged Traumatic Brain Dysfunction, Gifu, Japan.
Clin Endocrinol (Oxf). 2011 Sep;75(3):342-6. doi: 10.1111/j.1365-2265.2011.04072.x.
We aimed to elucidate the accuracy and limitations of [(18)F]-fluoro-L-dihydroxyphenylalanine ([(18) F]DOPA) positron emission tomography (PET) for Japanese patients with congenital hyperinsulinism. Although [(18)F]DOPA PET is reported to be useful for precisely localizing the focal form of congenital hyperinsulinism, previous reports are mostly from European and North American centres.
Seventeen Japanese infants with congenital hyperinsulinism.
[(18)F]DOPA PET studies were carried out, and the results were assessed by simple inspection or by a quantitative measurement termed the 'Pancreas Percentage', which expresses the uptake of the head, body or tail of the pancreas as a percentage of the total maximum standardized uptake value of the whole pancreas. The results were compared with those of other studies, including genetic analysis and histology.
By simple inspection, when a single focal uptake was obtained, the localization and histology were correct in all cases that underwent pancreatectomy. However, the overall results were consistent with the molecular diagnosis and histology in only 7/17 and 6/12 patients, respectively. The inaccuracy of PET studies by inspection was because of elevated background uptake that mimicked a diffuse or multifocal appearance. The accuracy improved substantially using the Pancreas Percentage; it was consistent with the molecular diagnosis and histology in 10/17 and 9/12 patients, respectively.
In contrast to the results of previous reports, [(18)F]DOPA PET appears to be less efficient for diagnosing Japanese patients with congenital hyperinsulinism. However, the diagnostic accuracy is substantially improved when this technique is combined with the Pancreas Percentage.
我们旨在阐明正电子发射断层扫描（PET）[(18)F]-氟代-L-二羟苯丙氨酸（[(18)F]DOPA）在日本先天性高胰岛素血症患者中的准确性和局限性。尽管[(18)F]DOPA PET 被报道可用于精确定位先天性高胰岛素血症的局灶性形式，但以前的报告主要来自欧洲和北美中心。
17 名日本先天性高胰岛素血症婴儿。
进行了[(18)F]DOPA PET 研究，并通过简单检查或称为“胰腺百分比”的定量测量来评估结果，该方法表示头、体或尾胰腺的摄取量占整个胰腺最大标准化摄取值的百分比。将结果与其他研究（包括基因分析和组织学）进行比较。
通过简单检查，当获得单个局灶性摄取时，所有接受胰腺切除术的病例的定位和组织学均正确。然而，总体结果仅分别与 7/17 和 6/12 例患者的分子诊断和组织学一致。检查时 PET 研究的不准确性是由于背景摄取升高而模拟出弥漫性或多灶性外观。使用胰腺百分比可大大提高准确性；它分别与 10/17 和 9/12 例患者的分子诊断和组织学一致。
与以前的报告结果相比，[(18)F]DOPA PET 似乎对诊断日本先天性高胰岛素血症患者的效率较低。然而，当将该技术与胰腺百分比相结合时，诊断准确性会大大提高。
