ECE2014 Poster Presentations Endocrine tumours and neoplasia (99 abstracts)
99mTc-GLP-1 scintigraphy, an efficient method for the detection of insulinoma: results of 3 years’ experience
Alicja Hubalewska-Dydejczyk 1 , Anna Sowa-Staszczak 1 , Dorota Pach 1 , Monika Tomaszuk 1 , Agnieszka Stefanska 1 , Monika Buziak-Bereza 1 , Agata Jabrocka-Hybel 1 , Aleksandra Gilis-Januszewska 1 , Maciej Malecki 2 , Tomasz Bednarczuk 3 , Grzegorz Kaminski 4 , Aldona Kowalska 5 , Malgorzata Trofimiuk-Muldner 1 , Renata Mikolajczak 6 & Barbara Janota 6
1Department of Endocrinology, Jagiellonian University Medical College, Krakow, Poland; 2Department of Metabolic Diseases, Jagiellonian University Medical College, Krakow, Poland; 3Department of Endocrinology, Medical University of Warsaw, Warsaw, Poland; 4Department of Endocrinology and Radioisotopic Therapy, Military Institute of Medicine, Warsaw, Poland; 5Department of Endocrinology and Nuclear Medicine, Holycross Cancer Center, Kielce, Poland; 6Radioisotope Center POLATOM, National Centre for Nuclear Research, Otwock, Poland.
Introduction: The aim of this study was to assess the diagnostic efficiency of [Lys40(Ahx-HYNIC-99mTc/EDDA)NH2]-exendin-4 scintigraphy in the detection of hardly detectable or not diagnosed by other available method insulinomas.
Materials and methods: 37 patients (24 women and 13 men, mean age 46.5±17.8 years, min. 16.0 years, max. 77.0 years) were enrolled in this study. There were 32 patients with clinical and biochemical symptoms and signs of insulinoma, one patient with malignant insulinoma, one patient with suspected local recurrence of malignant insulinoma (MEN1) and three with nesidioblastosis. In all patients prior examinations (CT/MRI/SRS) were negative or equivocal. The lyophilized kit provided by Radioisotope Center POLATOM was used for preparing the tracer. Whole-body and SPECT/CT scans at two points time points were performed.
Results: In 27 cases with suspicion of insulinoma a focal uptake in the pancreas was found – classified as insulinoma. In four negative cases reactive hypoglycaemia was diagnosed. In one case exogenous stimulation of insulin level by patient was revealed. In one case with malignant insulinoma pathological accumulation of the tracer was found only in the region of local recurrence. The GLP-1 study was negative in the other malignant insulinoma patient. In two patients with suspected nesidioblastosis diffuse accumulation of tracer was observed. In one case with suspicion of nesidioblastosis, a focal accumulation of the tracer was observed – histopathology revealed coexistence of insulinoma and nesidioblastosis.
Conclusion: 99mTc-GLP-1 receptor scintigraphy is a promising diagnostic tool for patients with clinical symptoms of insulinoma. It enables the localization of even very small tumours with excellent sensitivity and proper imaging is the most important step for successful surgery and complete patient recovery.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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