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利用[Lys40(Ahx-HYNIC-99mTc/EDDA)NH2]-exendin-4 对胰高血糖素样肽-1 受体进行成像，用于胰岛素瘤的检测。

Glucagon-like peptide-1 receptor imaging with [Lys40(Ahx-HYNIC- 99mTc/EDDA)NH2]-exendin-4 for the detection of insulinoma.

机构信息

Department of Endocrinology, Jagiellonian University Medical College, Cracow, Poland.

出版信息

Eur J Nucl Med Mol Imaging. 2013 Apr;40(4):524-31. doi: 10.1007/s00259-012-2299-1. Epub 2012 Dec 7.

DOI:10.1007/s00259-012-2299-1
PMID:23224740
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3590421/
Abstract

PURPOSE

The objective of this article is to present a new method for the diagnosis of insulinoma with the use of [Lys(40)(Ahx-HYNIC-(99m)Tc/EDDA)NH2]-exendin-4.

METHODS

Studies were performed in 11 patients with negative results of all available non-isotopic diagnostic methods (8 with symptoms of insulinoma, 2 with malignant insulinoma and 1 with nesidioblastosis). In all patients glucagon-like peptide-1 (GLP-1) receptor imaging (whole-body and single photon emission computed tomography/CT examinations) after the injection of 740 MBq of the tracer was performed.

RESULTS

Both sensitivity and specificity of GLP-1 receptor imaging were assessed to be 100 % in patients with benign insulinoma. In all eight cases with suspicion of insulinoma a focal uptake in the pancreas was found. In six patients surgical excision of the tumour was performed (type G1 tumours were confirmed histopathologically). In one patient surgical treatment is planned. One patient was disqualified from surgery. 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 one case with suspicion of nesidioblastosis, a focal accumulation of the tracer was observed and histopathology revealed coexistence of insulinoma and nesidioblastosis.

CONCLUSION

[Lys(40)(Ahx-HYNIC-(99m)Tc/EDDA)NH2]-exendin-4 seems to be a promising diagnostic tool in the localization of small insulinoma tumours, but requires verification in a larger series of patients.

摘要

目的

本文旨在介绍一种新的胰岛素瘤诊断方法，使用 [Lys(40)(Ahx-HYNIC-(99m)Tc/EDDA)NH2]-exendin-4。

方法

本研究纳入了 11 例经所有现有非同位素诊断方法（8 例有胰岛素瘤症状、2 例恶性胰岛素瘤和 1 例胰岛细胞瘤）检查结果均为阴性的患者。所有患者在注射 740 MBq 示踪剂后均行胰高血糖素样肽-1（GLP-1）受体显像（全身和单光子发射计算机断层扫描/CT 检查）。

结果

在良性胰岛素瘤患者中，GLP-1 受体显像的敏感性和特异性均为 100%。所有 8 例可疑胰岛素瘤患者的胰腺均发现局灶性摄取。6 例患者行肿瘤切除术（组织病理学证实为 G1 型肿瘤）。1 例患者计划手术治疗。1 例患者因手术禁忌而被排除。1 例恶性胰岛素瘤患者仅在局部复发区域发现示踪剂的病理性蓄积。另 1 例恶性胰岛素瘤患者的 GLP-1 研究为阴性。1 例可疑胰岛细胞瘤患者发现示踪剂局灶性积聚，组织病理学显示胰岛素瘤和胰岛细胞瘤共存。

结论

[Lys(40)(Ahx-HYNIC-(99m)Tc/EDDA)NH2]-exendin-4 似乎是一种有前途的用于定位小胰岛素瘤肿瘤的诊断工具，但需要在更大系列的患者中进行验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/397a/3590421/b4bdc1eef8a6/259_2012_2299_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/397a/3590421/faa346be3aae/259_2012_2299_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/397a/3590421/6ad92a7d245c/259_2012_2299_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/397a/3590421/b4bdc1eef8a6/259_2012_2299_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/397a/3590421/faa346be3aae/259_2012_2299_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/397a/3590421/6ad92a7d245c/259_2012_2299_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/397a/3590421/b4bdc1eef8a6/259_2012_2299_Fig3_HTML.jpg

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