ECEESPE2025 Poster Presentations Endocrine Related Cancer (76 abstracts)
[68Ga]Ga-DOTA-exendin-4 PET/CT for the localization of insulinoma: results of an international, dual-center, retrospective, open-label real-world imaging study
Emanuel Christ 1 , Manuela Schildmeijer 1 , Julia Fricke 1 , Katharina Laubner 2 , Lea Menz 2 , Jochen Seufert 2 , Martin Freitag 2 & Damian Wild 1
1University Hospital Basel, Division of Endocrinology, Diabetology and Metabolism, Basel, Switzerland; 2University Hospital of Freiburg, Division of Endocrinology and Diabetology, Department of Medicine II, Medical Center, Freiburg, Germany
JOINT1154
Introduction: Benign insulinomas are the main cause of endogenous hyperinsulinemic hypoglycemia (EHH) in adults, with surgery as the only cure. Pancreas-preserving procedures are preferred, making precise localization crucial. Recent studies indicate that GLP-1R imaging, such as [68Ga]Ga-DOTA-exendin-4 (68Ga-Ex4) PET/CT, outperforms conventional imaging in identifying insulinomas.
Aim: The goal of this study was to generate real-life data for the detection rate of insulinoma with 68Ga-Ex4 PET/CT in patients with negative/inconclusive workup on prior conventional imaging.
Material and Methods: In this retrospective, real-life, dual-center imaging study, patients with biochemically proven EHH and/or a positive Whipple triad underwent 68Ga-Ex4 PET/CT at two tertiary centers between April 2017 and March 2024. Endpoints: 68Ga-Ex4 PET/CT detection rate after inconclusive conventional workup (gold standard: histology) and impact on patient management.
Results: Hundred one patients were enrolled, of which 63 (62%) received conventional workup prior to 68Ga-Ex4 PET/CT. 68Ga-Ex4 PET/CT was positive in 26 out of the 35 patients with negative conventional workup leading to a PET/CT detection rate of 74% in this challenging patient group. 22/26 (85%) patients with positive results only with 68Ga-Ex4 PET/CT were confirmed by histology for either Insulinoma (21 cases) or nesidioblastosis (1 case).
Conclusions: In a real-life setting; 68Ga-Ex4 PET/CT effectively detects insulinomas and nesidioblastosis in patients with inconclusive conventional workup, achieving a 74% detection rate. Histology confirmed insulinomas or nesidioblastosis in all operated patients with positive 68Ga-Ex4 PET/CT results, highlighting its impact on patient management.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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