Evolution of Topical Diagnostic Algorithm for Pancreatic  Hormone-Producing Neuroendocrine Tumors

BACKGROUND: Insulinoma is a pancreatic neuroendocrine tumor that manifests by impaired carbohydrate metabolism with the development of hypoglycemic syndrome. The instrumental methods used at the present stage do not always make it possible to identify a tumor; moreover, the data obtained often contradict each other. Thus, the search for new possibilities of visualization of insulinoma is relevant.AIM: Evaluation of diagnostic effectiveness of scintigraphy with single-photon emission computed tomography combined with X-ray computed tomography (SPECT/CT) with 99mTc-Tectrotide for insulinoma in a Russian cohort of patients.MATERIALS AND METHODS: A single-centre (Endocrinology Research Centre of the Ministry of Health of the Russia), experimental, single-stage, controlled study. In the years 2017–2021 patients with pancreatic insulinoma (group 1) and hyperinsulinemic hypoglycemia of a different genesis (group 2) with negative or contradictory results of the 1st line imaging methods (ultrasound, magnetic resonance imaging (MRI), computed tomography (CT)) were included. All participants underwent the whole-body scintigraphy and low-dose SPECT/CT with 99mTc-Tectrotide (500–900 MBq). The studies were performed on a tomograph of the SPECT/GE Discovery NM/CT 670 using low-energy high-resolution collimators (LEHR) in the «whole body» mode.RESULTS: In the group 1 (n=21), according to the results of a pathomorphological study, the presence of 26 insulin-producing tumors was confirmed. Group 2 included 9 patients. According to the SPECT/CT with 99mTc-Tectrotide, 14 tumors were diagnosed in group 1 out of 26 insulin-producing tumors of the pancreas, and negative results were obtained in group 2 in 100% of cases. Thus, the sensitivity and specificity of the method were: 54%, 95% CI [33%; 73%] and 100%, 95% CI [68%; 100%], respectively.CONCLUSION: SPECT/CT with 99mTc-Tectrotide can detect insulinoma in 54% of cases with negative or contradictory results of 1st-line imaging methods (ultrasound, MRI, CT). This study can be effectively used as an alternative to SPECT/CT with 111In-octreotide, as a 2nd-line method for topical search for an insulin-producing pancreatic tumor.

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SPECT/CT with 99mTc-Tectrotide in the diagnosis of insulinoma

Yukina

Troshina

Nuralieva

et al. 2023

Obes. metabol.

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Insulinoma: analysis of prevalence and incidence in the world

Yukina,

Elfimova,

Troshina

et al. 2023

Endo Serg

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BACKGROUND: Currently, there are no data on the prevalence and incidence of insulinoma in Russia. The published world data on the epidemiology of the tumor are largely variable. Thus, it is important to systematize information on the prevalence and incidence of insulinoma in the world, including in Russia. AIM: To assess the prevalence and incidence of insulinoma in the world.TASKS Analysis of literature data.Analysis of the database of the Endocrinology Research Centre.MATERIALS AND METHODS: To implement Task 1, an analysis of foreign and Russian articles published in the PubMed and eLIBRARY.RU databases from 1927 was carried out until June 1, 2023, including the following keywords: «Insulinoma», «Epidemiology», «Frequency», «Incidence», «Nationwide», «Database». Based on the obtained results, an analysis of the prevalence and incidence of insulinoma in the world and in Russia was made. To implement Task 2, the analysis of patient records and the electronic database of the Endocrinology Research Centre was carried out.RESULTS: Based on data in individual countries the prevalence and incidence of insulinoma for the world population amounted to: an average of 16.4 per 1 million population and 0.9 per 1 million population per year, respectively. If extrapolating the world data, the number of patients with insulinoma in Russia can be 1066–2362 and 72–173 new cases are diagnosed annually (11.9 per 1 million population and 0.9 per 1 million population per year, respectively). The largest number of patients with insulinoma in Russia was recorded in the Endocrinology Research Centre and amounted to 275 cases for the period 2006–2022.CONCLUSION: In the Russian Federation, it is important to create a register of patients with insulinoma on the basis of the existing electronic database of the Endocrinology Research Centre in order to obtain accurate information about the current needs of patients with insulinoma in medical care and drug provision, as well as to conduct full-fledged scientific research.

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Evolution of Topical Diagnostic Algorithm for Pancreatic Hormone-Producing Neuroendocrine Tumors

Cited by 2 publications

References 12 publications

SPECT/CT with 99mTc-Tectrotide in the diagnosis of insulinoma

SPECT/CT with 99mTc-Tectrotide in the diagnosis of insulinoma

Insulinoma: analysis of prevalence and incidence in the world

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