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Glucagon-like peptide-1 versus somatostatin receptor targeting reveals 2 distinct forms of malignant insulinomas

Damian Wild, Emanuel Christ, Martyn E Caplin, Tom R Kurzawinski, Flavio Forrer, Michael Brändle, Jochen Seufert, Wolfgang A Weber, Jamshed Bomanji, Aurel Perren, Peter J Ell & Jean Claude Reubi

abstract

UNLABELLED
Glucagon-like peptide-1 (GLP-1) receptor imaging is superior to somatostatin receptor subtype 2 (sst(2)) imaging in localizing benign insulinomas. Here, the role of GLP-1 and sst(2) receptor imaging in the management of malignant insulinoma patients was investigated.

METHODS
Eleven patients with malignant insulinoma were prospectively included. (111)In-[Lys(40)(Ahx-diethylenetriaminepentaacetic acid [DTPA])NH(2)]-exendin-4 SPECT/CT, (68)Ga- 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 sst(2) 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 sst(2)-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 sst(2), which can be targeted therapeutically.
   
citation Wild D, Christ E, Caplin M E, Kurzawinski T R, Forrer F, Brändle M, Seufert J, Weber W A, Bomanji J, Perren A, Ell P J, Reubi J C. Glucagon-like peptide-1 versus somatostatin receptor targeting reveals 2 distinct forms of malignant insulinomas. J Nucl Med 2011; 52:1073-8.
   
type journal paper/review (English)
date of publishing 16-06-2011
journal title J Nucl Med (52/7)
ISSN electronic 1535-5667
pages 1073-8
PubMed 21680696
DOI 10.2967/jnumed.110.085142