Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2012) 29 OC9.5

ICEECE2012 Oral Communications Endocrine Tumours & Translation (6 abstracts)

Glucagon-like peptide 1 receptor (GLP-1R) imaging for the preoperative localization of benign insulinomas in 30 patients

E. Christ 1 , F. Forrer 2 , D. Wild 2 , T. Clerici 3 , M. Braendle 3 , H. Maecke 2 , P. Ell 4 , M. Caplin 5 , B. Gloor 1 & J. Reubi 6


1University Hospital of Bern, Inselspital, Bern, Switzerland; 2University Hospital of Basel, Basel, Switzerland; 3Kantonsspital St. Gallen, St. Gallen, Switzerland; 4University College Hospital, London, UK; 5Royal Free Hospital, London, UK; 6University of Bern, Bern, Switzerland.


Background: Although biochemical diagnosis of endogenous hyperinsulinemic hypoglycemia is straightforward, surgical removal of an insulinoma is hampered by difficulties to localize it using conventional radiological procedures (endosonography, MRI, CT-imaging techniques).

In vitro data suggest that human insulinoma cells exhibit a high density of GLP-1R. 111In-exendin-4 is a 111In labeled GLP-1R agonist that binds with high affinity to GLP-1R and may be helpful in localizing benign insulinomas.

Aim: To localize benign insulinomas using 111In-exendin-4 in patients with proven endogenous hyperinsulinemic hypoglycemia but no or only one suspicious lesion on conventional imaging.

Material and methods: 111In-exendin-4 was administered i.v. at a dose of (≈90 MBq; 30 μg peptide) over 5 min to 30 patients (18 females, 12 males, age±52.6±14.8 years, mean±S.D). Whole body planar images and SPECT/CT images (single photon emission computed tomography) of the abdomen were performed at 0.5 h, 4 h, 23 h, 96 h up to 168 h post injection. Diagnosis was confirmed by histology after surgical removal.

Results: Conventional imaging (MRI, CT, endosonography) was positive in 17 patients. 111In-exendin-4 SPECT/CT detected 23 true positive benign insulinomas and five additional positive lesions (one malignant insulinoma; two islets hyperplasia; two uncharacterized lesions). True negative tests were detected in two patients (one malignant insulinoma; one islets hyperplasia). There was no false negative result. The positive predictive value was 85% the negative predictive value 100%.

Conclusion: These data suggest that in vivo GLP-1R imaging defines a new non-invasive diagnostic approach to successfully localize small insulinomas.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This work was supported, however funding details are unavailable.

Volume 29

15th International & 14th European Congress of Endocrinology

European Society of Endocrinology 

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