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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 4/2013

Open Access 01-04-2013 | Original Article

Glucagon-like peptide-1 receptor imaging with [Lys40(Ahx-HYNIC-99mTc/EDDA)NH2]-exendin-4 for the detection of insulinoma

Authors: Anna Sowa-Staszczak, Dorota Pach, Renata Mikołajczak, Helmut Mäcke, Agata Jabrocka-Hybel, Agnieszka Stefańska, Monika Tomaszuk, Barbara Janota, Aleksandra Gilis-Januszewska, Maciej Małecki, Grzegorz Kamiński, Aldona Kowalska, Jan Kulig, Andrzej Matyja, Czesław Osuch, Alicja Hubalewska-Dydejczyk

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 4/2013

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Abstract

Purpose

The objective of this article is to present a new method for the diagnosis of insulinoma with the use of [Lys40(Ahx-HYNIC-99mTc/EDDA)NH2]-exendin-4.

Methods

Studies were performed in 11 patients with negative results of all available non-isotopic diagnostic methods (8 with symptoms of insulinoma, 2 with malignant insulinoma and 1 with nesidioblastosis). In all patients glucagon-like peptide-1 (GLP-1) receptor imaging (whole-body and single photon emission computed tomography/CT examinations) after the injection of 740 MBq of the tracer was performed.

Results

Both sensitivity and specificity of GLP-1 receptor imaging were assessed to be 100 % in patients with benign insulinoma. In all eight cases with suspicion of insulinoma a focal uptake in the pancreas was found. In six patients surgical excision of the tumour was performed (type G1 tumours were confirmed histopathologically). In one patient surgical treatment is planned. One patient was disqualified from surgery. In one case with malignant insulinoma pathological accumulation of the tracer was found only in the region of local recurrence. The GLP-1 study was negative in the other malignant insulinoma patient. In one case with suspicion of nesidioblastosis, a focal accumulation of the tracer was observed and histopathology revealed coexistence of insulinoma and nesidioblastosis.

Conclusion

[Lys40(Ahx-HYNIC-99mTc/EDDA)NH2]-exendin-4 seems to be a promising diagnostic tool in the localization of small insulinoma tumours, but requires verification in a larger series of patients.
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Metadata
Title
Glucagon-like peptide-1 receptor imaging with [Lys40(Ahx-HYNIC-99mTc/EDDA)NH2]-exendin-4 for the detection of insulinoma
Authors
Anna Sowa-Staszczak
Dorota Pach
Renata Mikołajczak
Helmut Mäcke
Agata Jabrocka-Hybel
Agnieszka Stefańska
Monika Tomaszuk
Barbara Janota
Aleksandra Gilis-Januszewska
Maciej Małecki
Grzegorz Kamiński
Aldona Kowalska
Jan Kulig
Andrzej Matyja
Czesław Osuch
Alicja Hubalewska-Dydejczyk
Publication date
01-04-2013
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 4/2013
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-012-2299-1

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