ECE2016 Eposter Presentations Endocrine tumours and neoplasia (68 abstracts)
Localization of benign insulinomas using glucagon-like peptide-1 receptor (GLP1-R) SPECT/CT and PET/CT in a prospective clinical study
Kwadwo Antwi 1 , Melpomeni Fani 1 , Tobias Heye 1 , Guillaume Nicolas 1 , Elmar Merkle 1 , Jean Claude Reubi 2 , Beat Gloor 3 , Damian Wild 1 & Emanuel Christ 4
1Clinic of Radiology and Nuclear Medicine, University Basel Hospital, Basel, Switzerland; 2Division of Experimental Pathology, Department of Pathology, University of Bern, Switzerland; 3Department of Visceral Surgery, University Hospital of Bern, Inselspital, Switzerland; 4Division of Endocrinology, Diabetology and Clinical Nutrition, University Hospital of Bern, Inselspital, Switzerland.
Purpose: The aim of our study is to compare the detection rate of GLP-1R PET/CT and GLP-1R SPECT/CT in patients with a biochemically proven endogenous hyperinsulinemic hypoglycemia. Preliminary results of an ongoing study are reported.
Methods: Thirty-three patients (25 females, 8 males, age range 18–80 years, mean 49 years) with neuroglycopenic symptoms due to endogenous hyperinsulinemic hypoglycemia were enrolled (ClinicalTrials.gov, NCT02127541).
Results: Previously performed cross-sectional imaging (CT/MRI) was negative or not conclusive in 25/33 (76%) of patients. 22 patients have been operated. In this collective, the histological diagnosis of a benign insulinoma was confirmed in 19 patients, one patient had adult islet cell hyperplasia. In one patient both intraoperative palpation and histological diagnosis did not confirm an insulinoma. In one patient symptoms of endogenous hypoglycemia ceased postoperative but histological diagnosis did not confirm the diagnosis. This patient was excluded from evaluation as the final diagnosis remained unclear. Two patients refused surgery. Five patients are awaiting surgery. In four patients PET/CT, SPECT/CT as well as the previous performed conventional imaging did not find any suspicious lesion and were thus not operated up to date. In this interim analysis PET/CT showed an overall pooled sensitivity of 93% SPECT/CT at 72 h showed an overall pooled sensitivity of 75% PET/CT was the only modality which correctly identified the area of islet cell hyperplasia (adult nesidioblastosis) within the pancreas.
Conclusion: Our interims analysis suggests that GLP-1R PET/CT performs better than GLP-1R SPECT/CT at a lower radiation dose and shorter examination time.
GLP-1R PET/CT will be a useful diagnostic tool in patients where cross sectional imaging (CT/MRI) fails to localize the insulinoma.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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