Nuklearmedizin 2020; 59(02): 127
DOI: 10.1055/s-0040-1708240
Wissenschaftliche Vorträge
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© Georg Thieme Verlag KG Stuttgart · New York

[ 68 Ga]Ga-NODAGA-exendin-4 PET/CT for the diagnosis and localization of focal congenital hyperinsulinism

M Boss
1   Radboudumc, Radiology and Nuclear Medicine, Nijmegen
,
P Shah
2   Great Ormond Street Hospital, London, Department of pediatric surgery, London
,
W Brenner
3   Charité University Hospital of Berlin, Department of Nuclear Medicine, Berlin
,
O Blankenstein
4   Charité University Hospital of Berlin, Department of Pediatric endocrinology, Berlin
,
C Rottenburger
5   University of Basel Hospital, Department of Nuclear Medicine, Basel
,
M Brom
1   Radboudumc, Radiology and Nuclear Medicine, Nijmegen
,
A Eek
1   Radboudumc, Radiology and Nuclear Medicine, Nijmegen
,
M Buitinga
1   Radboudumc, Radiology and Nuclear Medicine, Nijmegen
,
M Gotthardt
1   Radboudumc, Radiology and Nuclear Medicine, Nijmegen
› Author Affiliations
Further Information

Publication History

Publication Date:
08 April 2020 (online)

 

Ziel/Aim Congenital hyperinsulinism (CHI) is the most common cause of persistent and recurrent hypoglycemia in neonates. Focal CHI can be cured with partial pancreatectomy or limited lesionectomy. For this it is crucial to diagnose focal CHI and precisely localize the lesion. With [18F]F-DOPA PET, about 15 % of focal lesions are missed. The stable glucagon-like peptide 1 analogue exendin-4 specifically binds the glucagon-like peptide 1 receptor on pancreatic beta cells. 68Ga-labeled exendin has been shown to detect insulinomas with high sensitivity. We here included prospective as well as retrospective data of patients with CHI who underwent both [18F]F-DOPA PET and [68Ga]Ga-NODAGA-exendin-4 PET to compare the effectiveness of these two imaging techniques.

Methodik/Methods We analyzed data of 14 CHI patients (median age: 5 (2.2-9.4) months. All patients underwent [18F]F-DOPA PET and [68Ga]Ga-NODAGA-exendin-4 PET. For [68Ga]Ga-NODAGA-exendin-4 PET, 1 hour dynamic acquisitions from the time of injection, or 10 minute static acquisitions started 45 minutes post injection were obtained after injection of 1.6 MBq/kg [68Ga]Ga-NODAGA-exendin-4 (lower limit of 20 MBq). Images were analyzed by 2 non-blinded experts.

Ergebnisse/Results Analysis using histopathology as a reference standard showed a higher sensitivity of [68Ga]Ga-NODAGA-exendin-4 PET (100 % (CI 60-100 %)) than [18F]F-DOPA PET (57 % (CI 18-90 %)). SUVmax ratios between visually identified focal lesions and the area in the pancreas with the next highest tracer uptake are higher in GLP-1R PET than [18F]F-DOPA PET (1.83 ± 0.75 and 1.47 ± 0.43 respectively).

Schlussfolgerungen/Conclusions In this study we provide the first evidence of the possibility of diagnosis and localization of focal CHI using [68Ga]Ga-NODAGA-exendin-4 PET. These first results show a better sensitivity and image quality of [68Ga]Ga-NODAGA-exendin-4 PET compared to [18F]F-DOPA PET, demonstrating the potential of [68Ga]Ga-NODAGA-exendin-4 PET as a novel diagnostic tool for focal CHI.