Locating Pancreas Defects in Newborns

The arrow indicates the abnormal
cells in the newborn´s pancreas
© Children's Hospital of Philadelphia

study of 24 infants referred to the Hyperinsulinism Center at The Children's Hospital of Philadelphia between December 2004 and November 2005. All the children had congenital hyperinsulinism (HI) that could not be controlled with medicine. If this condition goes uncontrolled, abnormally high insulin levels may cause irreversible brain damage.

Congenital HI is caused by mutations that damage the insulin-secreting beta cells in the pancreas. Accurate diagnosis is important because focal disease, when the abnormal cells are limited to a discrete portion of the pancreas, can be cured by surgically removing the focal lesions. In diffuse disease, when the abnormal cells are distributed throughout the organ, surgeons may remove nearly the total pancreas, but that leaves the child at risk for later diabetes.

Using a mildly radioactive compound called 18F-fluoro-L-dihydroxyphenylalanine, or [18F]-DOPA, the researchers diagnosed focal or diffuse hyperinsulinism correctly in 23 of the 24 cases. In the 11 cases with focal hyperinsulinism, the technique was 100 percent accurate in pinpointing the abnormal lesions. [18F]-DOPA binds to the lesions, which then are visible to the naked eye on a body scanner.

“When we compared our findings from the PET scan with pathological results, we found 100 percent agreement in locating the focal lesions,” said Olga T. Hardy, M.D., a paediatric endocrinologist at Children's Hospital who was the study's lead author. “This accuracy is superior to that of invasive, technically difficult techniques that measure insulin sampled from specific veins in an infant.”

MEDICA.de; Source: Children's Hospital of Philadelphia