Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Feb;22(1):165-172.
doi: 10.1007/s11307-019-01372-z.

Superior Diagnostic Performance of the GLP-1 Receptor Agonist [Lys40(AhxHYNIC-[99mTc]/EDDA)NH2]-Exendin-4 over Conventional Imaging Modalities for Localization of Insulinoma

Katra Senica  1 , Ales Tomazic  2 , Ales Skvarca  3 , Petra Kolenc Peitl  1 , Renata Mikolajczak  4 , Alicja Hubalewska-Dydejczyk  5 , Luka Lezaic  6
Affiliations

Superior Diagnostic Performance of the GLP-1 Receptor Agonist [Lys40(AhxHYNIC-[99mTc]/EDDA)NH2]-Exendin-4 over Conventional Imaging Modalities for Localization of Insulinoma

Katra Senica et al. Mol Imaging Biol. 2020 Feb.

Abstract

Purpose: Insulinomas are the most common functioning neuroendocrine neoplasms of the pancreas, typically diagnosed due to characteristic symptoms. In the vast majority, the treatment is surgical and curative, requiring accurate localization of the tumour; conventional imaging, including somatostatin receptor molecular imaging, is negative in up to 10 % of cases. Recently, labelled glucagon-like peptide receptor (GLP-1R) analogues were introduced as a sensitive diagnostic method for localization of insulinomas. The aim of this study was to assess the diagnostic accuracy of a Tc-99m-labelled GLP-1R agonist [Lys40(AhxHYNIC-[99mTc]EDDA)NH2]-exendin-4 for localization of occult insulinoma.

Procedures: Eight patients (all females; age range 35-75 years) with biochemically proven insulinoma and with negative or inconclusive conventional imaging (consisting of somatostatin receptor scintigraphy, computed tomography, endoscopic ultrasound and magnetic resonance imaging) were enrolled. Whole-body single-photon emission tomography/computed tomography (SPECT/CT) imaging was performed 4 h post-injection of 740 MBq of [Lys40(AhxHYNIC-[99mTc]EDDA)NH2]-exendin-4. Surgical treatment was performed based on imaging findings. Histology of the removed lesions and biochemical and clinical symptom resolution was considered as the gold standard for analysis of the imaging results.

Results: Focal uptake of [Lys40(AhxHYNIC-[99mTc]EDDA)NH2]-exendin-4 was found in all patients, leading to successful removal of the offending lesion and complete biochemical and symptomatic resolution. Histological analysis confirmed insulinoma in all included patients.

Conclusions: [Lys40(AhxHYNIC-[99mTc]EDDA)NH2]-exendin-4 SPECT/CT appears to be an excellent molecular imaging method for preoperative localization of an occult insulinoma, surpassing conventional imaging methods. If routinely available, it could be considered as a method of choice due to its favorable combination of imaging characteristics.

Keywords: Exendin; GLP-1; GLP-1 receptor; Insulinoma; SPECT; SPECT/CT; Scintigraphy.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. J Clin Endocrinol Metab. 2017 Jan 1;102(1):195-199 - PubMed
    1. Theranostics. 2014 May 24;4(8):770-7 - PubMed
    1. Eur Radiol. 2009 Oct;19(10):2467-73 - PubMed
    1. Lancet Diabetes Endocrinol. 2013 Oct;1(2):115-22 - PubMed
    1. Q J Nucl Med Mol Imaging. 2016 Mar;60(1):69-76 - PubMed

MeSH terms

LinkOut - more resources