title: Localization of Hidden Insulinomas with ⁶⁸Ga-DOTA-Exendin-4 PET/CT: A Pilot Study.
abstract: (111)In-DOTA-exendin-4 SPECT/CT has been shown to be highly efficient in the detection of insulinomas. We aimed at determining whether novel PET/CT imaging with [Nle(14),Lys(40)(Ahx-DOTA-(68)Ga)NH2]exendin-4 ((68)Ga-DOTA-exendin-4) is feasible and sensitive in detecting benign insulinomas.
  
  
  METHODS
  (68)Ga-DOTA-exendin-4 PET/CT and (111)In-DOTA-exendin-4 SPECT/CT were performed in a randomized cross-over order on 5 patients with endogenous hyperinsulinemic hypoglycemia. The gold standard for comparison was the histologic diagnosis after surgery.
  
  
  RESULTS
  In 4 patients histologic diagnosis confirmed a benign insulinoma, whereas one patient refused surgery despite a positive (68)Ga-DOTA-exendin-4 PET/CT scan. In 4 of 5 patients, previously performed conventional imaging (CT or MR imaging) was not able to localize the insulinoma. (68)Ga-DOTA-exendin-4 PET/CT correctly identified the insulinoma in 4 of 4 patients, whereas (111)In-DOTA-exendin-4 SPECT/CT correctly identified the insulinoma in only 2 of 4 patients.
  
  
  CONCLUSIONS
  These preliminary data suggest that the use of (68)Ga-DOTA-exendin-4 PET/CT in detecting hidden insulinomas is feasible.
authors.affiliation: Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Basel, Switzerland.
authors.forename: Kwadwo
authors.initials: K
authors.lastname: Antwi
authors.affiliation: Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Basel, Switzerland.
authors.forename: Melpomeni
authors.initials: M
authors.lastname: Fani
authors.affiliation: Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Basel, Switzerland.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Nicolas
authors.affiliation: Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Basel, Switzerland.
authors.forename: Christof
authors.initials: C
authors.lastname: Rottenburger
authors.affiliation: Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Basel, Switzerland.
authors.forename: Tobias
authors.initials: T
authors.lastname: Heye
authors.affiliation: Division of Cell Biology and Experimental Cancer Research, Institute of Pathology, University of Bern, Bern, Switzerland.
authors.forename: Jean Claude
authors.initials: JC
authors.lastname: Reubi
authors.affiliation: Department of Visceral Surgery, University Hospital of Bern, Bern, Switzerland; and.
authors.forename: Beat
authors.initials: B
authors.lastname: Gloor
authors.affiliation: Division of Endocrinology, Diabetology, and Clinical Nutrition, University Hospital of Bern, Bern Switzerland.
authors.forename: Emanuel
authors.initials: E
authors.lastname: Christ
authors.affiliation: Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Basel, Switzerland damian.wild@usb.ch.
authors.forename: Damian
authors.initials: D
authors.lastname: Wild
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D003952:Diagnostic Imaging; D000077270:Exenatide; D005260:Female; D005710:Gallium Radioisotopes / Q000737:chemistry*; D005947:Glucose / Q000737:chemistry; D006573:Heterocyclic Compounds, 1-Ring / Q000737:chemistry*; D006801:Humans; D007150:Immunohistochemistry; D007340:Insulinoma / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D010455:Peptides / Q000737:chemistry*; D010865:Pilot Projects; D049268:Positron-Emission Tomography; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D014688:Venoms / Q000737:chemistry*; D051598:Whole Body Imaging
chemical_list: D005710:Gallium Radioisotopes; D006573:Heterocyclic Compounds, 1-Ring; D010455:Peptides; D014688:Venoms; C071349:1,4,7,10-tetraazacyclododecane- 1,4,7,10-tetraacetic acid; D000077270:Exenatide; D005947:Glucose
keywords: 68Ga; exendin-4; glucagon-like peptide-1 receptor targeting; insulinoma