PT  - JOURNAL ARTICLE
AU  - Damian Wild
AU  - Emanuel Christ
AU  - Martyn E. Caplin
AU  - Tom R. Kurzawinski
AU  - Flavio Forrer
AU  - Michael Brändle
AU  - Jochen Seufert
AU  - Wolfgang A. Weber
AU  - Jamshed Bomanji
AU  - Aurel Perren
AU  - Peter J. Ell
AU  - Jean Claude Reubi
TI  - Glucagon-Like Peptide-1 Versus Somatostatin Receptor Targeting Reveals 2 Distinct Forms of Malignant Insulinomas
AID  - 10.2967/jnumed.110.085142
DP  - 2011 Jul 01
TA  - Journal of Nuclear Medicine
PG  - 1073--1078
VI  - 52
IP  - 7
4099  - http://jnm.snmjournals.org/content/52/7/1073.short
4100  - http://jnm.snmjournals.org/content/52/7/1073.full
SO  - J Nucl Med2011 Jul 01; 52
AB  - Glucagon-like peptide-1 (GLP-1) receptor imaging is superior to somatostatin receptor subtype 2 (sst2) imaging in localizing benign insulinomas. Here, the role of GLP-1 and sst2 receptor imaging in the management of malignant insulinoma patients was investigated. Methods: Eleven patients with malignant insulinoma were prospectively included. 111In-[Lys40(Ahx-diethylenetriaminepentaacetic acid [DTPA])NH2]-exendin-4 SPECT/CT, 68Ga- DOTATATE PET/CT, and in vitro receptor autoradiography were performed to assess the receptor status and to evaluate the detection rate. Results: GLP-1 receptor targeting was positive in 4 of 11 patients, and sst2 receptor expression was positive in 8 of 11. In only 1 patient were both receptors expressed. In 1 patient, GLP-1 receptor imaging was the only method that successfully localized the primary tumor in the pancreas. In 3 patients with sst2-expressing tumors, DOTATATE radiotherapy was effectively applied. Conclusion: As opposed to benign insulinomas, malignant insulinomas often lack GLP-1 receptors. Conversely, malignant insulinomas often express sst2, which can be targeted therapeutically.