The comparison of three different molecular imaging methods in localization and grading of insulinoma

Chang, Lina; Bi, Xinyu; Li, Shuo; Tong, Qi; Gu, Yian; He, Zonghao; Li, Yansheng; Chen, Qiusong; Cui, Jingqiu; Yu, Haonan; He, Qing; Liu, Ming

doi:10.3389/fendo.2023.1163176

Cited by 3 publications

(1 citation statement)

References 31 publications

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“…La PET/CT con C-5hidroxi-triptofano (c-5-HTP) ha mostrado una sensibilidad >90 % para la detección de tumores de células de islotes pancreáticos, por su mayor actividad serotoninérgica (32,41). La PET/CT con agonistas del receptor del péptido 1 similar al glucagón (GLP-1R) Ga-exendina-4 tiene utilidad para la detección de insulinomas benignos, pero su precisión y sensibilidad disminuye en los insulinomas malignos, ya que el GLP-1R solo se sobreexpresa en el 36 % de los pacientes con insulinoma metastásico (26,42,43).…”

Section: Grupos De Estadios Pronósticosunclassified

Abordaje del insulinoma: revisión actualizada de la literatura

Castro Gomez,

Contreras Romero,

Afanador Jaimes

et al. 2024

Rev.ACE

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Contexto: el insulinoma se origina en las células ? de los islotes pancreáticos, donde la liberación de insulina es autónoma, pues evita los mecanismos de contrarregulación. Hay varios mecanismos fisiopatológicos propuestos, basados en la presencia de variantes patogénicas germinales o somáticas. Objetivo: aportar información sobre etiopatogenia, genética, epidemiología, clínica, diagnóstico, estadificación, localización, tratamiento y pronóstico del insulinoma. Metodología: revisión de la literatura en la base de datos PubMed, Google académico y literatura gris utilizando los términos MeSH: “insulinoma”, “physiopathology”, “epidemiology“, “signs and symptoms”, “diagnosis”, “therapeutics”, “prognosis”, “gastro-enteropancreatic neuroendocrine tumor”, y revisión del listado de referencias bibliográficas (en “bola de nieve”) de los estudios seleccionados. Resultados: el insulinoma es el tumor neuroendocrino pancreático funcional más frecuente con una clínica inespecífica que debe ser considerado ante la presencia de síntomas adrenérgicos y neuroglucopénicos, para el cual hay una gama de herramientas diagnósticas que se deben usar de manera complementaria dada su sensibilidad limitada, y el tratamiento debe ser orientado de acuerdo con la caracterización y estadificación del tumor. Conclusiones: el diagnóstico del insulinoma se retrasa durante varios años dada su clínica inespecífica, a pesar de su comportamiento mayormente benigno, se asociado a gran morbilidad.

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Section: Grupos De Estadios Pronósticosunclassified

Abordaje del insulinoma: revisión actualizada de la literatura

Castro Gomez,

Contreras Romero,

Afanador Jaimes

et al. 2024

Rev.ACE

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68Ga‐DOTATATE PET/CT: How is it reliable in imaging of cases having clinical suspicion of insulinomas?

Abdelkawi,

Romeih,

Nasr

et al. 2024

European Journal of Radiology

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Heterogeneity of Multiple Pancreatic Neuroendocrine Tumors Identified by <sup>68</sup>Ga-DOTANOC and <sup>68</sup>Ga-Exendin-4 PET/CT in a Patient with Endogenous Hyperinsulinemic Hypoglycemia and Multiple Endocrine Neoplasia 1

Xu,

Zhang

et al. 2024

Neuroendocrinology

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Insulinomas are the most frequent functional neuroendocrine tumors of pancreas. In about 10% cases, insulinomas are associated with hereditary syndrome including multiple endocrine neoplasia 1 (MEN1). Herein, we presented a case of 44-year-old female with recurrent hypoglycemia. In December 1998, this patient has undergone resection of two pancreatic lesions due to hypoglycemia and diagnosed as insulinoma. After operation, the symptom of hypoglycemia disappeared. However, from 2021, hypoglycemic symptoms reappeared frequently and even coma. In June 2023, enhanced CT showed multiple pancreatic lesions abundant with blood supply. Fasting serum blood glucose and insulin were 1.73mmol/L and 15.2U/L (2.6-11.8U/L). Germline genes suggested MEN1 pathogenic mutations. 68Ga-DOTANOC PET/CT indicated there were multiple lesions located in the pancreas and duodenum with high expression of somatostatin receptor (SSTR). 68Ga-exendin-4 PET/CT were added to localize the insulinoma. Most lesions with high expression of SSTR in body and tail of pancreas manifested part of them with high uptake of 68Ga-exendin-4, and an additional lesion with high expression of glucagon-like peptide 1 receptor was only detected by 68Ga-exendin-4 PET/CT. It showed highly heterogeneity. From the distal pancreatectomy, a total 5 tumors were found in the body and tail of pancreas, which were diagnosed as neuroendocrine tumors (NETs). After the operation, all the symptoms related to hypoglycemia disappeared. Immunohistochemical results of SSTR2 and insulin were consistent with the imaging finding of dual tracer PET/CT. From this case, combination of 68Ga-DOTANOC and 68Ga-exendin-4 PET/CT was recommended in the patients of MEN1 and insulinoma to estimate the heterogeneity of multiple neuroendocrine tumors that contributing to detect all the NET lesions and locate the tumors with secretion of insulin.

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The comparison of three different molecular imaging methods in localization and grading of insulinoma

Cited by 3 publications

References 31 publications

Abordaje del insulinoma: revisión actualizada de la literatura

Abordaje del insulinoma: revisión actualizada de la literatura

68Ga‐DOTATATE PET/CT: How is it reliable in imaging of cases having clinical suspicion of insulinomas?

Heterogeneity of Multiple Pancreatic Neuroendocrine Tumors Identified by <sup>68</sup>Ga-DOTANOC and <sup>68</sup>Ga-Exendin-4 PET/CT in a Patient with Endogenous Hyperinsulinemic Hypoglycemia and Multiple Endocrine Neoplasia 1

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