title: Glucagon-like peptide-1 receptor imaging with [Lys40(Ahx-HYNIC- 99mTc/EDDA)NH2]-exendin-4 for the detection of insulinoma.
abstract: OBJECTIVE
  The objective of this article is to present a new method for the diagnosis of insulinoma with the use of [Lys(40)(Ahx-HYNIC-(99m)Tc/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.
  
  
  CONCLUSIONS
  [Lys(40)(Ahx-HYNIC-(99m)Tc/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.
authors.affiliation: Department of Endocrinology, Jagiellonian University Medical College, Cracow, Poland. sowiana@gmail.com
authors.forename: Anna
authors.initials: A
authors.lastname: Sowa-Staszczak
authors.forename: Dorota
authors.initials: D
authors.lastname: Pach
authors.forename: Renata
authors.initials: R
authors.lastname: Mikołajczak
authors.forename: Helmut
authors.initials: H
authors.lastname: Mäcke
authors.forename: Agata
authors.initials: A
authors.lastname: Jabrocka-Hybel
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Stefańska
authors.forename: Monika
authors.initials: M
authors.lastname: Tomaszuk
authors.forename: Barbara
authors.initials: B
authors.lastname: Janota
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Gilis-Januszewska
authors.forename: Maciej
authors.initials: M
authors.lastname: Małecki
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Kamiński
authors.forename: Aldona
authors.initials: A
authors.lastname: Kowalska
authors.forename: Jan
authors.initials: J
authors.lastname: Kulig
authors.forename: Andrzej
authors.initials: A
authors.lastname: Matyja
authors.forename: Czesław
authors.initials: C
authors.lastname: Osuch
authors.forename: Alicja
authors.initials: A
authors.lastname: Hubalewska-Dydejczyk
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000077270:Exenatide; D005260:Female; D000067757:Glucagon-Like Peptide-1 Receptor; D006801:Humans; D006834:Hydrazines / Q000737:chemistry; D007004:Hypoglycemic Agents / Q000737:chemistry / Q000378:metabolism; D007340:Insulinoma / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009539:Nicotinic Acids / Q000737:chemistry; D015609:Organotechnetium Compounds / Q000737:chemistry; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D010455:Peptides / Q000737:chemistry / Q000378:metabolism; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000737:chemistry; D018027:Receptors, Glucagon / Q000032:analysis* / Q000378:metabolism; D014688:Venoms / Q000737:chemistry / Q000378:metabolism; D055815:Young Adult
chemical_list: C582908:(Lys40(Ahx-HYNIC-99mTc-EDDA)NH2)exendin-4; C120392:6-hydrazinopyridine-3-carboxylic acid; C000593833:GLP1R protein, human; D000067757:Glucagon-Like Peptide-1 Receptor; D006834:Hydrazines; D007004:Hypoglycemic Agents; D009539:Nicotinic Acids; D015609:Organotechnetium Compounds; D010455:Peptides; D019275:Radiopharmaceuticals; D018027:Receptors, Glucagon; D014688:Venoms; D000077270:Exenatide