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Utility of [F-18] fluoroDOPA for Neonatal Hyperinsulinism
This study is ongoing, but not recruiting participants.
First Received: May 5, 2008   Last Updated: January 25, 2009   History of Changes
Sponsor: University of Pennsylvania
Information provided by: University of Pennsylvania
ClinicalTrials.gov Identifier: NCT00674440
  Purpose

Children with congenital hyperinsulinism have low blood sugar, and some of these children may require surgery. In this study, researchers affiliated with the University of Pennsylvania will test how well a radioactive drug (called F-DOPA) can detect a form of hyperinsulinism that may be cured by surgery. Eligible participants in this study will have PET scans with F-DOPA prior to surgery.


Condition Intervention Phase
Congenital Hyperinsulinism
Hyperinsulinism
Persistent Hyperinsulinemic Hypoglycemia of Infancy
CHI
PHHI
Drug: F-DOPA
Phase II

Study Type: Interventional
Study Design: Diagnostic, Non-Randomized, Open Label, Parallel Assignment, Safety/Efficacy Study
Official Title: Localization of Focal Forms of Hyperinsulinism of Infancy With 18F-Labeled L-Fluoro-DOPA PET Scan

Resource links provided by NLM:


Further study details as provided by University of Pennsylvania:

Primary Outcome Measures:
  • The ability of FDOPA PET to identify forms of hyperinsulinism that may be cured by surgery: focal forms. [ Time Frame: one year ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Assess safety of F-DOPA PET. [ Time Frame: one year ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 100
Study Start Date: December 2004
Estimated Study Completion Date: June 2009
Primary Completion Date: December 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1: Experimental
Children diagnosed with hyperinsulinism who have failed other non-surgical interventions and will be scheduled for surgery. Eligible children in this arm may have PET imaging with F-DOPA prior to surgery.
Drug: F-DOPA
0.08-0.16 mCi/kg once
3: Experimental
Children diagnosed with hyperinsulinism who have had partial pancreas removal but still display signs of hyperinsulinism. Eligible children in this arm may have PET imaging with F-DOPA.
Drug: F-DOPA
0.08-0.16 mCi/kg once
2: Experimental
Children diagnosed with hyperinsulinism who are successfully managed with diazoxide, octreotide, other medications,and/or tube feedings. Eligible children in this arm may have PET imaging with F-DOPA.
Drug: F-DOPA
0.08-0.16 mCi/kg once

Detailed Description:

For children with congenital hyperinsulinism (CHI), low blood sugar is caused by cells in the pancreas that release too much insulin. Some children with CHI have these cells throughout their pancreas; others have them located in specific areas of the pancreas. Children who have them located in specific areas of the pancreas may be cured with surgery. F-DOPA is a radioactive drug that may go to these very cells. F-DOPA can also be used for positron emission tomography (or PET), an imaging technique used in nuclear medicine departments. In this study, researchers will test the possibility of using PET with F-DOPA in the diagnosis of children with hyperinsulinism.

  Eligibility

Ages Eligible for Study:   up to 18 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Any age, but primarily infants 0-6 months.
  • Children with confirmed diagnosis of congenital hyperinsulinism.

Exclusion Criteria:

  • Cases in which surgery will not be considered by parents or guardians.
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00674440

Locations
United States, Pennsylvania
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States, 19104
Sponsors and Collaborators
University of Pennsylvania
Investigators
Principal Investigator: Chaitanya R. Divgi, MD University of Pennsylvania
  More Information

Additional Information:
Publications:
Hardy OT, Hernandez-Pampaloni M, Saffer JR, Scheuermann JS, Ernst LM, Freifelder R, Zhuang H, MacMullen C, Becker S, Adzick NS, Divgi C, Alavi A, Stanley CA. Accuracy of [18F]fluorodopa positron emission tomography for diagnosing and localizing focal congenital hyperinsulinism. J Clin Endocrinol Metab. 2007 Dec;92(12):4706-11. Epub 2007 Sep 25.
Hardy OT, Hernandez-Pampaloni M, Saffer JR, Suchi M, Ruchelli E, Zhuang H, Ganguly A, Freifelder R, Adzick NS, Alavi A, Stanley CA. Diagnosis and localization of focal congenital hyperinsulinism by 18F-fluorodopa PET scan. J Pediatr. 2007 Feb;150(2):140-5.
Hussain K, Seppänen M, Näntö-Salonen K, Adzick NS, Stanley CA, Thornton P, Minn H. The diagnosis of ectopic focal hyperinsulinism of infancy with [18F]-dopa positron emission tomography. J Clin Endocrinol Metab. 2006 Aug;91(8):2839-42. Epub 2006 May 9.
Hardy OT, Litman RS. Congenital hyperinsulinism - a review of the disorder and a discussion of the anesthesia management. Paediatr Anaesth. 2007 Jul;17(7):616-21. Review.
Otonkoski T, Näntö-Salonen K, Seppänen M, Veijola R, Huopio H, Hussain K, Tapanainen P, Eskola O, Parkkola R, Ekström K, Guiot Y, Rahier J, Laakso M, Rintala R, Nuutila P, Minn H. Noninvasive diagnosis of focal hyperinsulinism of infancy with [18F]-DOPA positron emission tomography. Diabetes. 2006 Jan;55(1):13-8.
Ribeiro MJ, Boddaert N, Delzescaux T, Valayannopoulos V, Bellanné-Chantelot C, Jaubert F, Verkarre V, Nihoul-Fékété C, Brunelle F, De Lonlay P. Functional imaging of the pancreas: the role of [18F]fluoro-L-DOPA PET in the diagnosis of hyperinsulinism of infancy. Endocr Dev. 2007;12:55-66.
Subramaniam RM, Karantanis D, Peller PJ. [18F]Fluoro-L-dopa PET/CT in congenital hyperinsulinism. J Comput Assist Tomogr. 2007 Sep-Oct;31(5):770-2.
Ribeiro MJ, Boddaert N, Bellanné-Chantelot C, Bourgeois S, Valayannopoulos V, Delzescaux T, Jaubert F, Nihoul-Fékété C, Brunelle F, De Lonlay P. The added value of [18F]fluoro-L-DOPA PET in the diagnosis of hyperinsulinism of infancy: a retrospective study involving 49 children. Eur J Nucl Med Mol Imaging. 2007 Dec;34(12):2120-8. Epub 2007 Jul 28.
de Lonlay P, Simon-Carre A, Ribeiro MJ, Boddaert N, Giurgea I, Laborde K, Bellanné-Chantelot C, Verkarre V, Polak M, Rahier J, Syrota A, Seidenwurm D, Nihoul-Fékété C, Robert JJ, Brunelle F, Jaubert F. Congenital hyperinsulinism: pancreatic [18F]fluoro-L-dihydroxyphenylalanine (DOPA) positron emission tomography and immunohistochemistry study of DOPA decarboxylase and insulin secretion. J Clin Endocrinol Metab. 2006 Mar;91(3):933-40. Epub 2006 Jan 10.

Responsible Party: University of Pennsylvania ( Chaitanya R. Divgi, MD )
Study ID Numbers: 802337, 2004-3-3683, FD-R-003457-01
Study First Received: May 5, 2008
Last Updated: January 25, 2009
ClinicalTrials.gov Identifier: NCT00674440     History of Changes
Health Authority: United States: Food and Drug Administration

Keywords provided by University of Pennsylvania:
Congenital Hyperinsulinism
Hyperinsulinism
Persistent Hyperinsulinemic Hypoglycemia of Infancy
CHI
PHHI
F-DOPA
L-fluoro-dihydroxyphenylalanine

Additional relevant MeSH terms:
Nesidioblastosis
Hyperinsulinism
Digestive System Diseases
Metabolic Diseases
Infant, Newborn, Diseases
Pancreatic Diseases
Glucose Metabolism Disorders
Persistent Hyperinsulinemia Hypoglycemia of Infancy
Hypoglycemia

ClinicalTrials.gov processed this record on November 27, 2009