ECE2016 Eposter Presentations Endocrine tumours and neoplasia (68 abstracts)
Glucagon-like-1 Receptor imaging specifically localizes insulinomas in patients with Multiple Endocrine Neoplasia Type 1 (MEN-1)
Kwadwo Antwi 1 , Melpomeni Fani 1 , Tobias Heye 1 , Guillaume Nicolas 1 , Elmar Merkle 1 , François Pattou 2 , Ashley Grossmann 3 , Philippe Chanson 4 , Jean Claude Reubi 5 , Beat Gloor 6 , Damian Wild 1 & Emanuel Christ 7
1Clinic of Radiology and Nuclear Medicine, University of Basel Hsopital, Switzerland; 2Department of General and Endocrine Surgery, Lille University Hospital, France; 3Oxford Centre of Diabetes, Endocrinology and Metabolism, University of Oxford, UK; 4Division of Endocrinology, Hospital Bicetre and University Pari XI, France; 5Division of Experimental Pathology, University of Bern, Switzerland; 6Department of Visceral Surgery, University Hospital of Bern, Inselspital, Switzerland; 7Division of Diabetology, Endocrinology and Metabolism, University Hospital of Bern, Inselspital, Switzerland.
Introduction: Surgery is often the only treatment option that can effectively treat patients with insulinoma in MEN-1. However, the surgical intervention should be limited as surgery can not cure patients with MEN-1. It is, therefore, mandatory to correctly localize insulin secreting tumors from other neuroendocrine tumors.
Materials and Methods: In this report we include 6 patients with proven endogenous hyperinsulinemic hypoglycemia and neuroglycopenia in the context of MEN-1. All patients received abdominal SPECT/CT after the injection of a standard activity of 111In-Exendin-4. Four patients underwent additional imaging with a standardized contrast media enhanced 3T MRI and a 68Ga-DOTA-exendin-4 PET/CT scan as part of the study.
Results: Six patients (4 females and 2 males) were included (age range 18–49 years). Until today 5 of 6 patients have been operated. One patient refuses surgery until today. In the operated patients conventional imaging revealed a total of 11 suspicious pancreatic or peripancreatic lesions. PET/CT and SPECT/CT imaging together revealed 6 lesions with a high expression of Glucagon-like Peptide-1 receptors (GLP-1R) suspicious for an insulinoma. Based on the GLP-1R imaging all insulinoma suspicious lesions were surgically removed. Histology confirmed that all GLP-1 receptor positive lesions were insulinomas and all five patients presented with normalized postoperative blood sugar levels.
Conclusion: Adding GLP-1R imaging to conventional imaging is a helpful tool in differentiating insulinomas from other pancreatic islet tumors expressed in MEN-1 patient and may guide the surgical intervention.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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