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Differential diagnosis of morphological forms of congenital hyperinsulinism using [18F]-DOPA PET/CT

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Abstract


Congenital hyperinsulinism (CHI) is caused by insulin hyperproduction by β-pancreatic cells. CHI is associated with high risk of complications of chronic hypoglycemia, and therefore timely diagnosis of the disease and immediate initiation of therapy is a top-priority task. The choice of treatment tactics largely depends on the morphological form of the disease. Morphological form cannot be established based on clinical and laboratory presentation of the disease, ultrasound, MRI, computed and positron emission tomography (PET) with [18F]-fluorodeoxyglucose. Calcium stimulation test and percutaneous transhepatic blood sampling from the portal vein were previously used for differential diagnosis, but the results provided by these invasive studies are imprecise. At present, preoperative differential diagnosis of diffuse and focal forms of CHI is based on the data of genetic testing and radionuclide diagnosis ([18F]-DOPA PET). The article presents the first results of the use of [18F]-DOPA PET in CHI patients in the Russian Federation. Radionuclide study was performed in 17 patients with pharmacoresistant CHI followed by comparative analysis of the results of 18F-FDG PET/CT and histological picture of intraoperative pancreatic tissue samples, which is known as the gold standard for the differential diagnosis of HI histological forms.


Diliara N. Gubaeva

Endocrinology Research Certre

Author for correspondence.
Email: gubaevadn@gmail.com
ORCID iD: 0000-0003-3922-2869
SPIN-code: 3431-3323

Russian Federation, 11, Dm. Ulyanova street, Moscow, 117036

MD

Maria A. Melikyan

Endocrinology Research Certre

Email: melikian.maria@gmail.com
ORCID iD: 0000-0002-1491-2460
SPIN-code: 4184-4383

Russian Federation, 11, Dm. Ulyanova street, Moscow, 117036

MD, PhD, leading research associate

Daria V. Ryzhkova

Almazov National Medical Research Center

Email: d_ryjkova@mail.ru
ORCID iD: 0000-0002-7086-9153
SPIN-code: 7567-6920

Russian Federation, 2, Akkuratova str., Saint- Petersburg, 197341

MD, PhD, Professor

Lubov B. Mitrofanova

Almazov National Medical Research Center

Email: lubamitr@yandex.ru
ORCID iD: 0000-0003-0735-7822
SPIN-code: 9552-8248

Russian Federation, 2, Akkuratova str., Saint- Petersburg, 197341

MD, PhD

Irina L. Nikitina

Almazov National Medical Research Center

Email: nikitina0901@gmail.com
ORCID iD: 0000-0003-4013-0785
SPIN-code: 7707-4939

Russian Federation, 2, Akkuratova str., Saint- Petersburg, 197341

MD, PhD, Professor

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Supplementary files

Supplementary Files Action
1. Fig. 1, a. Results of positron emission tomography with [18F] -Fluoro-DOPA: focal form of WGI. View (960KB) Indexing metadata
2. Fig. 1, b. Results of positron emission tomography with [18F] -fluorodof: diffuse form of WGI. View (941KB) Indexing metadata

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Copyright (c) 2018 Gubaeva D.N., Melikyan M.A., Ryzhkova D.V., Mitrofanova L.B., Nikitina I.L.

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