Limited Value of 18F-F-DOPA PET to Localize Pancreatic Insulin-Secreting Tumors in Adults with Hyperinsulinemic Hypoglycemia

Tessonnier, Laurent; Sébag, F.; Ghander, C.; Micco, C. De; Reynaud, Rachel; Palazzo, Fausto; Conte-Devolx, B.; Henry, J. F.; Mundler, O.; Taïeb, David

doi:10.1210/jc.2009-1357

Cited by 79 publications

(38 citation statements)

References 18 publications

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“…Therefore, the expression of AADC has a key role in tumor visualization by 18 F-FDOPA PET (4). However, the intense and prolonged radiotracer uptake in the mature exocrine pancreas represents the main drawback of 18 F-FDOPA PET and may explain the initial disappointing results for insulinoma detection (5). Furthermore, early PET images and patient premedication with carbidopa may improve the diagnostic accuracy of 18 F-FDOPA PET in adult patients with insulinoma-related hyperinsulinemic hypoglycemia (6,7).…”

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confidence: 99%

Effect of Carbidopa on ¹⁸F-FDOPA Uptake in Insulinoma: From Cell Culture to Small-Animal PET Imaging

Détour¹,

Aimar²,

Boisson³

et al. 2016

J Nucl Med

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Patient premedication with carbidopa seems to improve the accuracy of 6-18 F-fluoro-3,4-dihydroxy-L-phenylalanine ( 18 F-FDOPA) PET for insulinoma diagnosis. However, the risk of PET false-negative results in the presence of carbidopa is a concern. Consequently, we aimed to evaluate the effect of carbidopa on 18 F-FDOPA uptake in insulinoma b-cells and an insulinoma xenograft model in mice. Methods: 18 F-FDOPA in vitro accumulation was assessed in the murine b-cell line RIN-m5F. In vivo small-animal PET experiments were performed on tumor-bearing nude mice after subcutaneous injection of RIN-m5F cells. Experiments were conducted with and without carbidopa pretreatment. Results: Incubation of RIN-m5F cells with 80 mM carbidopa did not significantly affect the cellular accumulation of 18 F-FDOPA. Tumor xenografts were clearly detectable by small-animal PET in all cases. Insulinoma xenografts in carbidopa-treated mice showed significantly higher 18 F-FDOPA uptake than those in nontreated mice. Regardless of carbidopa premedication, the xenografts were characterized by an early increase in 18 F-FDOPA uptake and then a progressive reduction over time. Conclusion: Carbidopa did not influence in vitro 18 F-FDOPA accumulation in RIN-m5F cells but improved insulinoma imaging in vivo. Our findings increase current knowledge about the 18 F-FDOPA uptake profile of RIN-m5F cells and a related xenograft model. To our knowledge, the present work represents the first preclinical research specifically focused on insulinomas, with potential translational implications.

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confidence: 99%

Effect of Carbidopa on ¹⁸F-FDOPA Uptake in Insulinoma: From Cell Culture to Small-Animal PET Imaging

Détour¹,

Aimar²,

Boisson³

et al. 2016

J Nucl Med

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“…The conventional imaging methods also have limited sensitivity because of the small size of insulinomas (9,10). The amine precursor 6-18 F-fluoro-Ldopa shows controversial results, with sensitivities ranging from 17% up to 90% (11,12). Only angiography in combination with intraarterial calcium stimulation and venous sampling has been shown to improve the sensitivity, but this is an invasive procedure with a concomitant risk of complications (13).…”

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confidence: 99%

Exendin-4–Based Radiopharmaceuticals for Glucagonlike Peptide-1 Receptor PET/CT and SPECT/CT

et al. 2010

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Tc/EDDA)NH 2 ]-exendin-4 did not result in inferior tumor-to-organ ratios or reduced image quality. All radiopeptides tested showed a high tumor-to-background ratio, resulting in the visualization of small tumors (maximum diameter between 1.0 and 3.2 mm) by SPECT and PET. The only exception was the kidneys, which also showed high uptake. This uptake could be reduced by 49%278% using poly-glutamic acid, Gelofusine, or a combination of the 2. The estimated effective radiation dose was 3.7 mSv/MBq for [Lys 40

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“…In addition, a masking effect of carbidopa on tumor uptake has been reported in case studies (17), and insulinomas with low aromatic amino acid decarboxylase expression may be potentially more sensitive to carbidopa inhibition (18). In previously published studies, all patients had already undergone contrast-enhanced CT at the time of 18 F-FDOPA PET/CT examination (12)(13)(14). We wanted to examine the diagnostic benefit of implementing a 'one-stop' protocol using this hybrid imaging modality.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, the potential diagnostic benefit of a contrast enhanced CT component was not utilized in these studies (12)(13)(14).…”

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confidence: 99%

Clinical Value of 18F-FDOPA PET/CT With Contrast Enhancement and Without Carbidopa Premedication in Patients with Insulinoma

Nakuz

Berger

El-Rabadi

et al. 2018

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Limited Value of 18F-F-DOPA PET to Localize Pancreatic Insulin-Secreting Tumors in Adults with Hyperinsulinemic Hypoglycemia

Abstract: 18F-FDOPA PET is of limited value in localizing pancreatic insulin secreting tumors in adult HH. Our results contrast with the referential study and require further analysis.

Cited by 79 publications

References 18 publications

Effect of Carbidopa on ¹⁸F-FDOPA Uptake in Insulinoma: From Cell Culture to Small-Animal PET Imaging

Effect of Carbidopa on ¹⁸F-FDOPA Uptake in Insulinoma: From Cell Culture to Small-Animal PET Imaging

Exendin-4–Based Radiopharmaceuticals for Glucagonlike Peptide-1 Receptor PET/CT and SPECT/CT

Clinical Value of 18F-FDOPA PET/CT With Contrast Enhancement and Without Carbidopa Premedication in Patients with Insulinoma

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Limited Value of 18F-F-DOPA PET to Localize Pancreatic Insulin-Secreting Tumors in Adults with Hyperinsulinemic Hypoglycemia

Abstract: 18F-FDOPA PET is of limited value in localizing pancreatic insulin secreting tumors in adult HH. Our results contrast with the referential study and require further analysis.

Cited by 79 publications

References 18 publications

Effect of Carbidopa on 18F-FDOPA Uptake in Insulinoma: From Cell Culture to Small-Animal PET Imaging

Effect of Carbidopa on 18F-FDOPA Uptake in Insulinoma: From Cell Culture to Small-Animal PET Imaging

Exendin-4–Based Radiopharmaceuticals for Glucagonlike Peptide-1 Receptor PET/CT and SPECT/CT

Clinical Value of 18F-FDOPA PET/CT With Contrast Enhancement and Without Carbidopa Premedication in Patients with Insulinoma

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Effect of Carbidopa on ¹⁸F-FDOPA Uptake in Insulinoma: From Cell Culture to Small-Animal PET Imaging

Effect of Carbidopa on ¹⁸F-FDOPA Uptake in Insulinoma: From Cell Culture to Small-Animal PET Imaging