From the Service de Médecine Nucléaire, Hôpital Tenon AP-HP and Sorbonne University.
Endocrinology, Hôpital Saint-Antoine AP-HP and Sorbonne University, Paris.
Clin Nucl Med. 2022 May 1;47(5):394-401. doi: 10.1097/RLU.0000000000004126.
The aim of this study was to assess the performance of 68Ga-DOTATOC PET/CT in the detection and extension of insulinomas according to 3 different contexts: sporadic benign, sporadic metastatic, and multiple endocrine neoplasia type 1 (MEN1).
The data of 71 adult patients who underwent 68Ga-DOTATOC PET/CT for suspected or confirmed sporadic insulinoma, suspicion of insulinoma in the context of MEN1, follow-up of metastatic insulinoma, or suspicion of recurrence of insulinoma were retrospectively analyzed. Pathological examination or strong clinical and biological findings were used as standards of truth.
For the assessment of a confirmed sporadic insulinoma in 17 patients, the sensitivity of SR-PET was 75%, including 2 patients for whom metastatic lesions had been revealed by SR-PET. For 35 patients with a suspicion of insulinoma, the sensitivity was 39%. In 10 patients followed up for metastatic insulinoma, the sensitivity was 100%. For 5 patients with a history of MEN1, interpretation of SR-PET was difficult, as 3 of them presented with multiple pancreatic uptake foci. The global sensitivity of SR-PET in all insulinomas excluding those with a MEN1 story was 64% (100% for metastatic insulinomas, 62% for benign insulinomas), with a specificity of 89%.
68Ga-DOTATOC PET/CT is a useful examination tool for the assessment of insulinomas in selected contexts, with very high performance for the detection and extension workup of metastatic insulinomas and high specificity for the detection of sporadic benign insulinomas. The examination should be completed with GLP-1 receptor PET when it is negative or in a MEN1 context.
本研究旨在评估 68Ga-DOTATOC PET/CT 在检测和扩展胰岛素瘤方面的性能，根据 3 种不同的情况：散发性良性、散发性转移性和多发性内分泌肿瘤 1 型（MEN1）。
回顾性分析了 71 例成年患者的资料，这些患者因疑似或确诊的散发性胰岛素瘤、MEN1 背景下的胰岛素瘤疑似、转移性胰岛素瘤的随访或疑似胰岛素瘤复发而接受了 68Ga-DOTATOC PET/CT 检查。病理检查或强烈的临床和生物学发现被用作金标准。
在 17 例确诊的散发性胰岛素瘤患者中，SR-PET 的敏感性为 75%，包括 2 例转移性病变被 SR-PET 发现的患者。在 35 例疑似胰岛素瘤的患者中，敏感性为 39%。在 10 例转移性胰岛素瘤随访患者中，敏感性为 100%。在 5 例有 MEN1 病史的患者中，SR-PET 的解读较为困难，因为其中 3 例存在多个胰腺摄取灶。在所有排除 MEN1 病史的胰岛素瘤中，SR-PET 的总体敏感性为 64%（转移性胰岛素瘤为 100%，良性胰岛素瘤为 62%），特异性为 89%。
68Ga-DOTATOC PET/CT 是一种在特定情况下评估胰岛素瘤的有用检查工具，对转移性胰岛素瘤的检测和扩展工作具有非常高的性能，对散发性良性胰岛素瘤的检测具有高特异性。如果检查结果为阴性或在 MEN1 背景下，应结合 GLP-1 受体 PET 进行检查。
