ECE2011 Poster Presentations Endocrine tumours and neoplasia (37 abstracts)
Could 99mTc labeled long-acting agonist of GLP-1 (Exendin-4) scintigraphy be a new tool in the diagnostics of unknown focus of insulinoma ? preliminary results
A H D Hubalewska-dydejczyk 1, , D P Pach 1, , A S S Sowa-Staszczak 1, , A J H Jabrocka-Hybel 1, , A S Stefanska 1, , A G J Gilis-Januszewska 1, , R M Mikolajczak 1, & B J Janota 1,
1Chair and Department of Endocrinology, Jagiellonian University, Krakow, Poland; 2Institute of Atomic Energy POLATOM, Świerk, Poland.
Introduction: GLP-1 receptors have been fund on different types of neoplasm’ cells and density of these receptors appears to be more frequent in some of them. GLP-1 receptor scanning offers a new approach for successful localization of small or not detectable by other methods insulinomas and other cancers such as MTC, gastrinoma, pheochromocytoma, gastrinoma, etc.
Aim of the study: The aim of study was to present first successful experiences with the use of 99mTc-labeled [Lys40-(Ahx-HYNIC)NH2]-Exendin-4 (Exendin-4 is a long-acting GLP-1 agonist) scintigraphy in localization of unknown insulinoma focus.
Material and method: [Lys40(Ahx-HYNIC-99mTc/EDDA)NH2]-Exendin-4 receptor scintigraphy was performed in three patients. The insulinoma was suspected in two of them: a 57-year-old women with sever clinical hypoglycaemias, no lesion in CT and no uptake of the tracer in somatostatin receptor scintigraphy (SRS), and in 16-year-old man with hiperinsulinemia, small unclear lesion in CT and no uptake of the tracer in SRS. A 62-year-old women with malignant insulinoma after surgery with metastases to the liver in CT was qualified to scintigraphy with suspicion of the disease recurrence and no pathological uptake in SRS.
Results: In both suspected insulinoma cases, the uptake of [Lys40(Ahx-HYNIC-99mTc/EDDA)NH2]-Exendin-4 in pancreas was found. The first patient had successful surgery, revealing small lesions of insulinoma. For the second patient, fusion of images confirmed that pathological accumulation of tracer localized in pancreas; patient has been referred to surgery. In patient with malignant insulinoma the uptake of the tracer was in the place suspected as recurrence.
Conclusion: Promising pharmakokinetic data and the preliminary results of our study showed that [Lys 40NH2 (Ahx)-HYNIC]-Exendin – 4 – 99mTc could be suitable candidate for clinical GLP-1 receptor imaging in clinical practice.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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