68Ga-DOTANOC PET/CT mimicking renal dynamic scan: Lack of physiological uptake in the spleen of a newborn and the pituitary gland in congenital hyperinsulinism

2014 ◽  
Vol 33 (6) ◽  
pp. 382-383
Author(s):  
G. Kumar ◽  
V.S. Dhull ◽  
S. Karunanithi ◽  
C. Bal ◽  
R. Kumar
Keyword(s):  
Pituitary Gland ◽  
Congenital Hyperinsulinism ◽  
Physiological Uptake ◽  
Pet Ct ◽  
Dynamic Scan

Radiation exposure of patients during 68Ga-DOTATOC PET/CT examinations

2009 ◽  
Vol 48 (05) ◽  
pp. 201-207 ◽  
Author(s):  
K. Zöphel ◽  
R. Freudenberg ◽  
L. Oehme ◽  
M. Andreeff ◽  
G. Wunderlich ◽  
...  
Keyword(s):  
Pituitary Gland ◽  
Radiation Exposure ◽  
Somatostatin Receptor ◽  
Blood Pool ◽  
Biological Data ◽  
Whole Body ◽  
Physiological Uptake ◽  
Standardized Uptake Values ◽  
Pet Ct ◽  
Routine Clinical Setting

Summary Aim: Investigation of the biodistribution and calculation of dosimetry of Ga-68-DOTATOCfor patients imaged in the routine clinical setting for diagnosis or exclusion of neuroendocrine tumours. Patients, methods: Dynamic PET/CT-imaging (Biograph 16) was performed over 20 min in 14 patients (8 men, 6 women) after injection of (112 ± 22) MBq 68Ga-DOTATOC followed by whole body 3D-acquisition (8 bed positions, 3 or 4 min each) 30 min p.i. and 120 min p.i. Urinary tracer elimination was measured and blood activity was derived non-invasively from the blood pool of the heart. The relevant organs for dosimetry were spleen, kidneys, liver, adrenals, urinary bladder and pituitary gland. Dosimetry was performed using OLINDA/ EXM 1.0 software and specific organ uptake was expressed as standardized uptake values (SUVs). Results: Rapid physiological uptake of the radiotracer could be demonstrated in liver, spleen and kidneys, adrenals and pituitary gland (mean SUVs were 6, 20, 16, 10, and 4, respectively). Radiotracer elimination was exclusively via urine (16% of injected dose within 2h); no redistribution could be observed. The spleen and the kidneys received the highest radiation exposure (0.24 mSv/MBq, 0.22 mSv/MBq resp.), mean effective dose yielded 0.023 mSv/MBq. Conclusion: 68Ga-DOTATOC is used extensively for diagnosis of somatostatin receptor positive tumours because it has several advantages over the 111In-labelled ligand. The derived dosimetric values are lower than first approximations from the biological data of OctreoScan. The use of CT for transmission correction of the PET data delivers radiation exposure up to 1 mSv (low dose).

scholarly journals The combination of 13N-ammonia and 11C-methionine in differentiation of residual/recurrent pituitary adenoma from the pituitary gland remnant after trans-sphenoidal Adenomectomy

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fangling Zhang ◽  
Qiao He ◽  
Ganhua Luo ◽  
Yali Long ◽  
Ruocheng Li ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Pituitary Adenoma ◽  
Pituitary Gland ◽  
Gray Matter ◽  
Standard Uptake Value ◽  
Visual Evaluation ◽  
Additional Surgery ◽  
Pet Ct ◽  
Histological Confirmation ◽  
G Ratio

Abstract Background This study aimed to assess the clinical usefulness of 13N-ammonia and 11C- Methionine (MET) positron emission tomography (PET)/ computed tomography (CT) in the differentiation of residual/recurrent pituitary adenoma (RPA) from the pituitary gland remnant (PGR) after trans-sphenoidal adenomectomy. Methods Between June 2012 and December 2019, a total of 19 patients with a history of trans-sphenoidal adenomectomy before PET/CT scans and histological confirmation of RPA after additional surgery in our hospital were enrolled in this study. Images were interpreted by visual evaluation and semi-quantitative analysis. In semi-quantitative analysis, the maximum standard uptake value (SUVmax) of the target and gray matter was measured and the target uptake/gray matter uptake (T/G) ratio was calculated. Results The T/G ratios of 13N-ammonia were significantly higher in PGR than RPA (1.58 ± 0.69 vs 0.63 ± 1.37, P < 0.001), whereas the T/G ratios of 11C-MET were obviously lower in PGR than RPA (0.78 ± 0.35 vs 2.17 ± 0.54, P < 0.001). Using the canonical discriminant analysis, we calculated the predicted accuracy of RPA (100%), PGR (92.9%), and the overall predicted accuracy (96.43%). Conclusions The combination of 13N-ammonia and 11C-MET PET/CT is valuable in the differentiation of RPA from PGR after trans-sphenoidal adenomectomy.

scholarly journals GMP production of 6-[18F]Fluoro-l-DOPA for PET/CT imaging by different synthetic routes: a three center experience

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Valdemar L. Andersen ◽  
Mikkel A. Soerensen ◽  
Johan Hygum Dam ◽  
Niels Langkjaer ◽  
Henrik Petersen ◽  
...  
Keyword(s):  
Radiochemical Yield ◽  
Ct Imaging ◽  
University Hospital ◽  
Dopamine Synthesis ◽  
Congenital Hyperinsulinism ◽  
Molar Activity ◽  
Time Period ◽  
Pet Ct ◽  
Synthetic Routes ◽  
Radiochemical Yields

Abstract Background The radiofluorinated levodopa analogue 6-[18F]F-l-DOPA (3,4-dihydroxy-6-18F-l-phenylalanine) is a commonly employed radiotracer for PET/CT imaging of multiple oncological and neurological indications. An unusually large number of different radiosyntheses have been published to the point where two different Ph. Eur. monographs exist depending on whether the chemistry relies on electrophilic or nucleophilic radiosubstitution of appropriate chemical precursors. For new PET imaging sites wishing to adopt [18F]FDOPA into clinical practice, selecting the appropriate production process may be difficult and dependent on the clinical needs of the site. Methods Data from four years of [18F]FDOPA production at three different clinical sites are collected and compared. These three sites, Aarhus University Hospital (AUH), Odense University Hospital (OUH), and Herlev University Hospital (HUH), produce the radiotracer by different radiosynthetic routes with AUH adopting an electrophilic strategy, while OUH and HUH employ two different nucleophilic approaches. Production failure rates, radiochemical yields, and molar activities are compared across sites and time. Additionally, the clinical use of the radiotracer over the time period considered at the different sites are presented and discussed. Results The electrophilic substitution route suffers from being demanding in terms of cyclotron operation and maintenance. This challenge, however, was found to be compensated by a production failure rate significantly below that of both nucleophilic approaches; a result of simpler chemistry. The five-step nucleophilic approach employed at HUH produces superior radiochemical yields compared to the three-step approach adopted at OUH but suffers from the need for more comprehensive synthesis equipment given the multi-step nature of the procedure, including HPLC purification. While the procedure at OUH furnishes the lowest radiochemical yield of the synthetic routes considered, it produces the highest molar activity. This is of importance across the clinical applications of the tracer discussed here, including dopamine synthesis in striatum of subjects with schizophrenia and congenital hyperinsulinism in infants. Conclusion For most sites either of the two nucleophilic substitution strategies should be favored. However, which of the two will depend on whether a given site wishes to optimize the radiochemical yield or the ease of the use.

scholarly journals Genotype and phenotype analysis of a cohort of patients with congenital hyperinsulinism based on DOPA-PET CT scanning

2019 ◽  
Vol 178 (8) ◽  
pp. 1161-1169 ◽  
Author(s):  
Jinwen Ni ◽  
Jingjie Ge ◽  
Miaoying Zhang ◽  
Khalid Hussain ◽  
Yihui Guan ◽  
...  
Keyword(s):  
Ct Scanning ◽  
Congenital Hyperinsulinism ◽  
Pet Ct ◽  
Phenotype Analysis

scholarly journals 68Ga-NOTA-exendin-4 PET/CT in detection of occult insulinoma and evaluation of physiological uptake

2014 ◽  
Vol 42 (3) ◽  
pp. 531-532 ◽  
Author(s):  
Yaping Luo ◽  
Miao Yu ◽  
QingQing Pan ◽  
Wenming Wu ◽  
Taiping Zhang ◽  
...  
Keyword(s):  
Physiological Uptake ◽  
Pet Ct

scholarly journals Paternally inherited ABCC8 mutation causing diffuse congenital hyperinsulinism

2013 ◽  
Vol 2013 ◽  
Author(s):  
Suresh Chandran ◽  
Fabian Yap Kok Peng ◽  
Victor Samuel Rajadurai ◽  
Yap Te Lu ◽  
Kenneth T E Chang ◽  
...  
Keyword(s):  
Ct Scan ◽  
Severe Hypoglycaemia ◽  
Congenital Hyperinsulinism ◽  
List Type ◽  
Focal Lesions ◽  
Hyperinsulinaemic Hypoglycaemia ◽  
Partial Pancreatectomy ◽  
Diffuse Disease ◽  
Pet Ct ◽  
Pet Ct Scan

Summary background: Congenital hyperinsulinism (CHI) is a rare genetic disorder characterised by inappropriate insulin secretion in the face of severe hypoglycaemia. There are two histological subtypes of CHI namely diffuse and focal. Diffuse CHI is most common due to recessive mutations in ABCC8/KCNJ11 (which encode the SUR/KIR6.2 components of the pancreatic β-cell KATP channel) whereas focal CHI is due to a paternally inherited ABCC8/KCNJ11 mutation and somatic loss of heterozygosity for the 11p allele inside the focal lesion. Fluorine-18-l-dihydroxyphenylalanine positron emission tomography/computed tomography (18F-DOPA-PET/CT) is used in the pre-operative localisation of focal lesions prior to surgery. Diffuse CHI if medically unresponsive will require a near total pancreatectomy whereas focal CHI will only require a limited lesionectomy, thus curing the patient from the hypoglycaemia. Aims: To report the first case of genetically confirmed CHI in Singapore from a heterozygous paternally inherited ABCC8 mutation. Methods/Results: A term male infant presented with severe hyperinsulinaemic hypoglycaemia (HH) after birth and failed medical treatment with diazoxide and octreotide. Genetic testing (paternally inherited mutation in ABCC8/p.D1472N) suggested focal disease, but due to the unavailability of 18F-DOPA-PET/CT to confirm focal disease, a partial pancreatectomy was performed. Interestingly, histology of the resected pancreatic tissue showed changes typical of diffuse disease. Conclusion: Heterozygous paternally inherited ABCC8/KCNJ11 mutations can lead to diffuse or focal CHI. Learning points HH is a cause of severe hypoglycaemia in the newborn period. Paternal mutations in ABCC8/KCNJ11 can lead to diffuse or focal disease. 18F-DOPA-PET/CT scan is the current imaging of choice for localising focal lesions. Gallium-68 tetra-aza-cyclododecane-N N′N″N-‴-tetra-acetate octreotate PET scan is not a useful imaging tool for localising focal lesions. The molecular mechanism by which a heterozygous ABCC8 mutation leads to diffuse disease is currently unclear. Focal lesions are curable by lesionectomy and so genetic studies in patients with HH must be followed by imaging using 18F-DOPA-PET/CT scan.

scholarly journals 18F-DOPA PET/CT and 68Ga-DOTANOC PET/CT scans as diagnostic tools in focal congenital hyperinsulinism: a blinded evaluation

2017 ◽  
Vol 45 (2) ◽  
pp. 250-261 ◽  
Author(s):  
Charlotte Dahl Christiansen ◽  
Henrik Petersen ◽  
Anne Lerberg Nielsen ◽  
Sönke Detlefsen ◽  
Klaus Brusgaard ◽  
...  
Keyword(s):  
Ct Scans ◽  
Diagnostic Tools ◽  
Congenital Hyperinsulinism ◽  
Pet Ct

scholarly journals The contribution of rapid KATP channel gene mutation analysis to the clinical management of children with congenital hyperinsulinism

2011 ◽  
Vol 164 (5) ◽  
pp. 733-740 ◽  
Author(s):  
I Banerjee ◽  
M Skae ◽  
S E Flanagan ◽  
L Rigby ◽  
L Patel ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Clinical Management ◽  
Ct Scanning ◽  
Favourable Outcome ◽  
Compound Heterozygous ◽  
Congenital Hyperinsulinism ◽  
Subtotal Pancreatectomy ◽  
Pathogenic Mutations ◽  
Positron Emission ◽  
Pet Ct

ObjectiveIn children with congenital hyperinsulinism (CHI), KATP channel genes (ABCC8 and KCNJ11) can be screened rapidly for potential pathogenic mutations. We aimed to assess the contribution of rapid genetic testing to the clinical management of CHI.DesignFollow-up observational study at two CHI referral hospitals.MethodsClinical outcomes such as subtotal pancreatectomy, 18F-Dopa positron emission tomography–computed tomography (PET–CT) scanning, stability on medical treatment and remission were assessed in a cohort of 101 children with CHI.ResultsIn total, 32 (32%) children had pathogenic mutations in KATP channel genes (27 in ABCC8 and five in KCNJ11), of which 11 (34%) were novel. In those negative at initial screening, other mutations (GLUD1, GCK, and HNF4A) were identified in three children. Those with homozygous/compound heterozygous ABCC8/KCNJ11 mutations were more likely to require a subtotal pancreatectomy CHI (7/10, 70%). Those with paternal heterozygous mutations were investigated with 18F-Dopa PET–CT scanning and 7/13 (54%) had a focal lesionectomy, whereas four (31%) required subtotal pancreatectomy for diffuse CHI. Those with maternal heterozygous mutations were most likely to achieve remission (5/5, 100%). In 66 with no identified mutation, 43 (65%) achieved remission, 22 (33%) were stable on medical treatment and only one child required a subtotal pancreatectomy.ConclusionsRapid genetic analysis is important in the management pathway of CHI; it provides aetiological confirmation of the diagnosis, indicates the likely need for a subtotal pancreatectomy and identifies those who require 18F-Dopa PET–CT scanning. In the absence of a mutation, reassurance of a favourable outcome can be given early in the course of CHI.

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