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Peer-reviewedCC BY 4.0EJNMMI Reports

Unusual [18F]FDOPA PET-CT maging of insulinomas in children

  • Sameera Hannah Auckburally1,2
  • Ross J. Craigie3
  • Konrad Mohnike4
  • Sabrina Alam5
  • Sarah Worthington1,6
  • Indraneel Banerjee1
  • Rakesh Sajjan2
6 affiliations
  1. 1Department of Paediatric Endocrinology, Royal Manchester Children’s Hospital, Manchester, UK
  2. 2Department of Nuclear Medicine, Royal Manchester Children’s Hospital, Manchester, UK
  3. 3Department of Paediatric Surgery, Royal Manchester Children’s Hospital, Manchester, UK
  4. 4Diagnostic and Therapeutic Center, Frankfurter Tor (DTZ), Berlin, Germany
  5. 5Department of Paediatric Radiology, Royal Manchester Children’s Hospital, Manchester, UK
  6. 6Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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Abstract

Purpose: Insulinomas are rare pancreatic neuroendocrine tumours, causing recurrent episodes of hypoglycaemia. Accurate localisation is essential for surgical management, yet imaging remains challenging. This case series presents unusual findings of paediatric insulinomas on [18F]-dihydroxyphenylalanine ([18F]FDOPA) positron emission tomography-computed tomography (PET-CT) imaging.

Methods: We retrospectively reviewed medical notes and investigations of histologically proven paediatric insulinoma cases (n=4) presenting to Royal Manchester Children’s Hospital between 2008 and 2024. All patients underwent [18F]FDOPA PET-CT as part of their diagnostic workup. Imaging findings were analysed, with particular attention to tracer uptake patterns.

Results: Contrary to the increased tracer uptake typically seen in neuroendocrine tumours, three of the four insulinomas demonstrated focal photopenia at the site of the tumour on [18F]FDOPA PET-CT. Only one case showed increased uptake, suggesting a predominance of reduced, rather than enhanced, tracer activity in paediatric insulinomas

Conclusion: Photopenia on [18F]FDOPA PET-CT may be a more frequent finding than increased uptake in paediatric insulinomas. Recognizing this atypical pattern is important for accurate tumour localisation before surgical management. Further studies are needed to validate these findings and find a mechanistic explanation.

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Cite

BibTeXRIS
BibTeX
@article{auckburally2026unusual,
  title = {{Unusual [18F]FDOPA PET-CT maging of insulinomas in children}},
  author = {Sameera Hannah Auckburally and Ross J. Craigie and Konrad Mohnike and Sabrina Alam and Sarah Worthington and Indraneel Banerjee and Rakesh Sajjan},
  journal = {EJNMMI Reports},
  year = {2026},
  month = oct,
  doi = {10.1186/s41824-026-00331-6},
  url = {https://doi.org/10.1186/s41824-026-00331-6},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Unusual [18F]FDOPA PET-CT maging of insulinomas in children
AU  - Sameera Hannah Auckburally
AU  - Ross J. Craigie
AU  - Konrad Mohnike
AU  - Sabrina Alam
AU  - Sarah Worthington
AU  - Indraneel Banerjee
AU  - Rakesh Sajjan
PY  - 2026
DA  - 2026/10/28
JO  - EJNMMI Reports
DO  - 10.1186/s41824-026-00331-6
UR  - https://doi.org/10.1186/s41824-026-00331-6
AB  - Purpose: Insulinomas are rare pancreatic neuroendocrine tumours, causing recurrent episodes of hypoglycaemia. Accurate localisation is essential for surgical management, yet imaging remains challenging. This case series presents unusual findings of paediatric insulinomas on [18F]-dihydroxyphenylalanine ([18F]FDOPA) positron emission tomography-computed tomography (PET-CT) imaging.  Methods: We retrospectively reviewed medical notes and investigations of histologically proven paediatric insulinoma cases (n=4) presenting to Royal Manchester Children’s Hospital between 2008 and 2024. All patients underwent [18F]FDOPA PET-CT as part of their diagnostic workup. Imaging findings were analysed, with particular attention to tracer uptake patterns.  Results: Contrary to the increased tracer uptake typically seen in neuroendocrine tumours, three of the four insulinomas demonstrated focal photopenia at the site of the tumour on [18F]FDOPA PET-CT. Only one case showed increased uptake, suggesting a predominance of reduced, rather than enhanced, tracer activity in paediatric insulinomas  Conclusion: Photopenia on [18F]FDOPA PET-CT may be a more frequent finding than increased uptake in paediatric insulinomas. Recognizing this atypical pattern is important for accurate tumour localisation before surgical management. Further studies are needed to validate these findings and find a mechanistic explanation.
SN  - 3005-074X
ER  -