Abstract
1512
Background: Insulinoma is an islet-cell neoplasm that secretes insulin. It is usually localized to the pancreas and is often the most common cause of endogenous hyperinsulinemic hypoglycaemia in non-diabetic adult patients. Surgical excision with a curative intent is the standard modality of treatment, and it requires precise localization of tumor tissue. 68Gallium-DOTA-exendin-4 PET/CT scan is a clinically reasonable and sensitive scan for the identification of insulinoma. The aim of this prospective cohort study was to determine the overall accuracy of 68Gallium-DOTA-exendin-4 PET/CT scan in the detection of insulinoma. Materials and Methods: Eight patients with fasting hyperinsulinemic hypoglycaemia with neuroglycopenic symptoms were enrolled in this study which was conducted from October 2016 to October 2017. Whole body PET/CT scan was performed on a Philips time of flight PET/CT scanner, 60 minutes after injection of 68Gallium-DOTA-exendin-4 (and also 68Gallium-DOTANOC). The imaging findings were compared to the histopathological diagnosis in six out of eight patients and to subsequent follow up in the remaining two patients who did not undergo surgery.
Results: The sensitivity and specificity of 68Gallium-DOTA-Exendin-4 PET/CT scan in insulinoma detection was found to be 75% and 100% respectively. Overall accuracy was 87.5%. Conclusion: 68Gallium-DOTA-Exendin-4 PET/CT scan is highly sensitive for identification and exact localization of insulinoma which can guide better surgical exploration. However, randomised controlled trials are needed to assess the accuracy of 68Gallium-DOTA-Exendin PET/CT scan in localization of insulinoma.