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Glucagon-Like Peptide-1 Receptor PET/CT with 68Ga-NOTA-Exendin-4 for Detecting Localized Insulinoma: A Prospective Cohort Study.
- Source :
-
Journal of nuclear medicine : official publication, Society of Nuclear Medicine [J Nucl Med] 2016 May; Vol. 57 (5), pp. 715-20. Date of Electronic Publication: 2016 Jan 21. - Publication Year :
- 2016
-
Abstract
- Unlabelled: Preoperative localization of insulinoma is a clinical dilemma. We aimed to investigate whether glucagon-like peptide-1 receptor (GLP-1R) PET/CT with (68)Ga-NOTA-MAL-cys(40)-exendin-4 ((68)Ga-NOTA-exendin-4) is efficient in detecting insulinoma.<br />Methods: In our prospective cohort study, patients with endogenous hyperinsulinemic hypoglycemia were enrolled. CT, MRI, endoscopic ultrasound, and (99m)Tc-hydrazinonicotinamide-TOC SPECT/CT were done according to standard protocols. GLP-1R PET/CT was performed 30-60 min after the injection of (68)Ga-NOTA-exendin-4. The gold standard for diagnosis was the histopathologic results after surgery.<br />Results: Of 52 recruited patients, 43 patients with histopathologically proven insulinomas were included for the imaging studies. Nine patients did not undergo surgical intervention. (68)Ga-NOTA-exendin-4 PET/CT correctly detected insulinomas in 42 of 43 patients with high tumor uptake (mean SUVavg ± SD, 10.2 ± 4.9; mean SUVmax ± SD, 23.6 ± 11.7), resulting in sensitivity of 97.7%. In contrast, (99m)Tc-hydrazinonicotinamide-TOC SPECT/CT showed a low sensitivity of 19.5% (8/41) in this group of patients; however, it successfully localized the tumor that was false-negative with GLP-1R PET/CT. The sensitivities of CT, MR, and endoscopic ultrasonography were 74.4% (32/43), 56.0% (14/25), and 84.0% (21/25), respectively.<br />Conclusion: (68)Ga-NOTA-exendin-4 PET/CT is a highly sensitive imaging technique for the localization of insulinoma.<br /> (© 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.)
- Subjects :
- Adolescent
Adult
Aged
Child
Cohort Studies
Exenatide
Female
Heterocyclic Compounds, 1-Ring
Humans
Insulinoma metabolism
Insulinoma pathology
Male
Middle Aged
Pancreatic Neoplasms metabolism
Pancreatic Neoplasms pathology
Prospective Studies
Young Adult
Gallium Radioisotopes
Glucagon-Like Peptide-1 Receptor metabolism
Heterocyclic Compounds chemistry
Insulinoma diagnostic imaging
Pancreatic Neoplasms diagnostic imaging
Peptides chemistry
Positron Emission Tomography Computed Tomography
Venoms chemistry
Subjects
Details
- Language :
- English
- ISSN :
- 1535-5667
- Volume :
- 57
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of nuclear medicine : official publication, Society of Nuclear Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 26795291
- Full Text :
- https://doi.org/10.2967/jnumed.115.167445