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16.05.2019 | Research Article

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

verfasst von: Katra Senica, Ales Tomazic, Ales Skvarca, Petra Kolenc Peitl, Renata Mikolajczak, Alicja Hubalewska-Dydejczyk, Luka Lezaic

Erschienen in: Molecular Imaging and Biology | Ausgabe 1/2020

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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.

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Titel: Superior Diagnostic Performance of the GLP-1 Receptor Agonist [Lys40(AhxHYNIC-[99mTc]/EDDA)NH2]-Exendin-4 over Conventional Imaging Modalities for Localization of Insulinoma
verfasst von: Katra Senica
Ales Tomazic
Ales Skvarca
Petra Kolenc Peitl
Renata Mikolajczak
Alicja Hubalewska-Dydejczyk
Luka Lezaic
Publikationsdatum: 16.05.2019
Verlag: Springer International Publishing
Erschienen in: Molecular Imaging and Biology / Ausgabe 1/2020
Print ISSN: 1536-1632
Elektronische ISSN: 1860-2002
DOI: https://doi.org/10.1007/s11307-019-01372-z

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

Abstract

Purpose

Procedures

Results

Conclusions

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