Diabetologie und Stoffwechsel 2025; 20(S 01): S99
DOI: 10.1055/s-0045-1807555
Abstracts | DDG 2025
Poster
Posterwalk 15: Sonstige Themen

68Ga-DOTA-Exendin-4 PET/CT for the localization of insulinoma: Results of an international, dual-center, retrospective, open-label real-world imaging study

Authors

  • L Menz

    1   Uniklinik Freiburg, Endokrinologie, Freiburg, Germany

  • J Fricke

    2   Unispital Basel, Nuklearmedizin, Basel, Switzerland

  • E Christ

    3   Unispital Basel, Endokrinologie, Basel, Switzerland

  • M Schildmeijer

    3   Unispital Basel, Endokrinologie, Basel, Switzerland

  • D Wild

    2   Unispital Basel, Nuklearmedizin, Basel, Switzerland

  • M Freitag

    4   Uniklinik Freiburg, Nuklearmedizin, Freiburg, Germany

  • J Seufert

    1   Uniklinik Freiburg, Endokrinologie, Freiburg, Germany

  • K Laubner

    1   Uniklinik Freiburg, Endokrinologie, Freiburg, Germany
Further Information
Also available at
 
 

    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 or 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 One hundred and 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.


     

    Interessenkonflikt

    Disclosure of interest: None declared

    Publication History

    Article published online:
    28 May 2025

    © 2025. Thieme. All rights reserved.

    Georg Thieme Verlag KG
    Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany