Comparison of Glucagon-Like-Peptide-1 (GLP-1) Receptor PET/CT, SPECT/CT and 3T MRI for the Localisation of Insulinomas: Evaluation of Accuracy in a Prospective Crossover Imaging Study

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Introduction: Benign insulinomas are the most prevalent cause of endogenous hyperinsulinaemic hypoglycaemia (EHH) in adults and due to their small size difficult to localise.

Aim(s): We aimed at prospectively comparing the accuracy and clinical impact of glucagon-like-peptide-1 receptor (GLP1-R) PET/CT, SPECT/CT, standardised 3-Tesla contrast-enhanced (ce)MRI and non-standardised baseline imaging (ceCT/ceMRI) in patients with EHH.

Materials and methods: We prospectively enrolled patients with neuroglycopenic symptoms due to EHH and no evidence for metastatic disease on conventional imaging. Standardised ceMRI was performed using clinical routine sequences. SPECT/CT was performed 4h/72h after injection of 111In-DOTA-exendin-4 and PET/CT 2,5h after injection of 68Ga-DOTA-exendin-4 in a randomized, cross over design. The reference standard was surgery with histology and normalisation of blood glucose levels within 10 days.

Conference: 15th Annual ENETSConcerence (2018)

Presenting Author:

Authors: Antwi A, Heye T, Fani M, Nicolas G, Merkle E,

Keywords: Insulinoma, neuroendocrine tumor, GLP-1R imaging,