ArticleClinical nuclear medicine2025
68 Ga-NODAGA-EXENDIN-4 PET/CT in the Detection or the Exclusion of Occult Sporadic Insulinomas.
Article in Clinical nuclear medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- 68Ga-DOTA-exendin-4 PET/CT for insulinoma localization in patients with negative or inconclusive conventional imaging.The Journal of clinical endocrinology and metabolism · 2026Article
- Glucagon-like peptide-1 receptor PET/CT in gastrinomas: a case series demonstrating the precise characterization to guide surgical and medical treatment.EJNMMI reports · 2026Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe diagnosis and localization of insulinomas remain challenging. Imaging with contrast-enhanced CT, PET with somatostatin analogs, MRI, and endoscopic ultrasonography is often inconclusive. GLP1 receptor radioligands can specifically target insulinomas. A recent multicenter trial reported the superior performance of 68 Ga-NODAGA-Exendin-4 (EX) PET/CT for the detection of benign insulinomas. PATIENTS AND
methodsFifty EX-PET/CTs (individually authorized by the French Medicine Agency) were performed on 44 patients with a suspected sporadic insulinoma, based on biochemistry and clinical signs, but without a target lesion identified by imaging. A composite reference standard was based on postsurgical histology and/or follow-up data over 6-45 months after the EX-PET/CT.
resultsThe examination-based EX-PET/CT positivity rate was 62% (31/50), equivocal 0. Positive EX-PET/CTs were confirmed by the outcomes of all 29 EX-guided resections (PPV 100%), including 2 re-operations following partial resection. Furthermore, the suspected diagnosis of an insulinoma was abandoned in 12 patients after 14 of 19 negative EX-PET/CTs. Suspicion of occult insulinoma remained in 5 patients. EX-PET/CT performed similarly well in patients treated by antihypoglycemic drugs and/or younger than 18 years. Since no extra-pancreatic EX abnormal foci were observed, the EX-PET/CT field-of-view to the upper abdomen should be sufficient. Only 1 patient experienced symptomatic hypoglycemia after EX injection.
conclusionsIn cases of suspected insulinomas with nondiagnostic imaging, the performance of EX-PET/CT for the detection of nonmalignant sporadic insulinomas was excellent, with a 29/50 (58%) rate of major impact on patients' management. A negative EX-PET/CT appears to be a confident predictor to rule out the presence of sporadic insulinoma.
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