TY - JOUR T1 - Glucagon-Like Peptide-1 Receptor PET/CT with <sup>68</sup>Ga-NOTA-Exendin-4 for Detecting Localized Insulinoma: A Prospective Cohort Study JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 715 LP - 720 DO - 10.2967/jnumed.115.167445 VL - 57 IS - 5 AU - Yaping Luo AU - Qingqing Pan AU - Shaobo Yao AU - Miao Yu AU - Wenming Wu AU - Huadan Xue AU - Dale O. Kiesewetter AU - Zhaohui Zhu AU - Fang Li AU - Yupei Zhao AU - Xiaoyuan Chen Y1 - 2016/05/01 UR - http://jnm.snmjournals.org/content/57/5/715.abstract N2 - Preoperative localization of insulinoma is a clinical dilemma. We aimed to investigate whether glucagon-like peptide-1 receptor (GLP-1R) PET/CT with 68Ga-NOTA-MAL-cys40-exendin-4 (68Ga-NOTA-exendin-4) is efficient in detecting insulinoma. Methods: In our prospective cohort study, patients with endogenous hyperinsulinemic hypoglycemia were enrolled. CT, MRI, endoscopic ultrasound, and 99mTc-hydrazinonicotinamide-TOC SPECT/CT were done according to standard protocols. GLP-1R PET/CT was performed 30–60 min after the injection of 68Ga-NOTA-exendin-4. The gold standard for diagnosis was the histopathologic results after surgery. Results: Of 52 recruited patients, 43 patients with histopathologically proven insulinomas were included for the imaging studies. Nine patients did not undergo surgical intervention. 68Ga-NOTA-exendin-4 PET/CT correctly detected insulinomas in 42 of 43 patients with high tumor uptake (mean SUVavg ± SD, 10.2 ± 4.9; mean SUVmax ± SD, 23.6 ± 11.7), resulting in sensitivity of 97.7%. In contrast, 99mTc-hydrazinonicotinamide-TOC SPECT/CT showed a low sensitivity of 19.5% (8/41) in this group of patients; however, it successfully localized the tumor that was false-negative with GLP-1R PET/CT. The sensitivities of CT, MR, and endoscopic ultrasonography were 74.4% (32/43), 56.0% (14/25), and 84.0% (21/25), respectively. Conclusion: 68Ga-NOTA-exendin-4 PET/CT is a highly sensitive imaging technique for the localization of insulinoma. ER -