title: Detection of insulitis by pancreatic scintigraphy with 99mTc-labeled IL-2 and MRI in patients with LADA (Action LADA 10).
abstract: OBJECTIVE
  Pancreatic scintigraphy with interleukin-2 radiolabeled with (99m)Tc ((99m)Tc-IL-2) is a technique used to image chronic inflammatory-mediated disorders. We used this method to detect a signal consistent with the presence of insulitis in patients with autoimmune diabetes. Positive and negative controls (patients with pancreatic carcinoma and type 2 diabetes, respectively) also were studied.
  
  
  METHODS
  We examined 25 patients with autoimmune diabetes (16 with recently diagnosed type 1 diabetes, 9 with latent autoimmune diabetes in adults [LADA]), 6 with type 2 diabetes, and 7 with pancreatic carcinoma (the latter two groups were used as negative and positive controls, respectively). All patients underwent (99m)Tc-IL-2 scintigraphy and contrast-enhanced MRI of the pancreas. To validate positive controls, samples were taken from patients with pancreatic carcinoma during surgery for histological and immunohistochemical investigations.
  
  
  RESULTS
  Pancreatic accumulation of (99m)Tc-IL-2 was detected in patients with autoimmune diabetes (61% positive) and, notably, in 6 of 9 patients with LADA; semiquantitative evaluation of pancreatic uptake of (99m)Tc-IL-2 showed higher values in patients with autoimmune diabetes (both childhood and LADA) and pancreatic carcinoma than in those with type 2 diabetes (4.45 ± 1.99, 4.79 ± 1.1, and 4.54 ± 1.62 vs. 2.81 ± 0.63; P = 0.06, P = 0.01, and P = 0.04, respectively). In patients with pancreatic carcinoma, pancreatic interleukin-2 receptor expression correlated with pancreatic (99m)Tc-IL-2 uptake (r = 0.8; P = 0.01). In patients with LADA, (99m)Tc-IL-2 uptake inversely correlated with duration of disease (r = 0.7; P = 0.03).
  
  
  CONCLUSIONS
  Autoimmune diabetes in adults is associated with increased pancreatic (99m)Tc-IL-2 uptake, indicating the presence of insulitis, particularly within 1 year of the beginning of insulin therapy, similar to type 1 diabetes at diagnosis.
authors: Nuclear Medicine Unit, Faculty of Medicine and Psychology, University "Sapienza," Rome, Italy Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
authors: Alberto
authors: A
authors: Signore
authors: Nuclear Medicine Unit, Faculty of Medicine and Psychology, University "Sapienza," Rome, Italy.
authors: Gabriela
authors: G
authors: Capriotti
authors: Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands Regina Apostolorum Hospital, Albano, Rome, Italy.
authors: Marco
authors: M
authors: Chianelli
authors: Department of Biopathology and Diagnostic Imaging, University "Tor Vergata," Rome, Italy.
authors: Elena
authors: E
authors: Bonanno
authors: Nuclear Medicine Unit, Faculty of Medicine and Psychology, University "Sapienza," Rome, Italy.
authors: Filippo
authors: F
authors: Galli
authors: Department of Radiological Science, University "Sapienza," Rome, Italy.
authors: Carlo
authors: C
authors: Catalano
authors: Department of Radiology, Clínica Colsanitas, Bogotà, Colombia.
authors: Ana M
authors: AM
authors: Quintero
authors: Department of Surgery Science, University "Sapienza," Rome, Italy.
authors: Giorgio
authors: G
authors: De Toma
authors: Department of Endocrinology and Diabetes, University Campus Bio-Medico, Rome, Italy.
authors: Silvia
authors: S
authors: Manfrini
authors: Department of Endocrinology and Diabetes, University Campus Bio-Medico, Rome, Italy Centre of Diabetes, St. Bartholomew's and The London School of Medicine, Queen Mary, University of London, London, U.K. p.pozzilli@unicampus.it.
authors: Paolo
authors: P
authors: Pozzilli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003287:Contrast Media; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000276:immunology; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000276:immunology; D005260:Female; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D007330:Insulin Antibodies / Q000032:analysis*; D007376:Interleukin-2; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D010195:Pancreatitis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D055815:Young Adult
chemical_list: D003287:Contrast Media; D007328:Insulin; D007330:Insulin Antibodies; D007376:Interleukin-2; D015609:Organotechnetium Compounds; C481016:technetium Tc 99m interleukin 2