Boss, Marti;
Rottenburger, Christof;
Brenner, Winfried;
Blankenstein, Oliver;
Prasad, Vikas;
Prasad, Sonal;
de Coppi, Paolo;
... Gotthardt, Martin; + view all
(2022)
Ga-68-NODAGA-Exendin-4 PET/CT Improves the Detection of Focal Congenital Hyperinsulinism.
Journal of Nuclear Medicine
, 63
(2)
pp. 310-315.
10.2967/jnumed.121.262327.
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Abstract
Surgery with curative intent can be offered to congenital hyperinsulinism (CHI) patients, provided that the lesion is focal. Radiolabeled exendin-4 specifically binds the glucagonlike peptide 1 receptor on pancreatic b-cells. In this study, we compared the performance of 18F-DOPA PET/CT, the current standard imaging method for CHI, and PET/CT with the new tracer 68Ga-NODAGA-exendin-4 in the preoperative detection of focal CHI. Methods: Nineteen CHI patients underwent both 18F-DOPA PET/CT and 68Ga-NODAGA-exendin-4 PET/CT before surgery. The images were evaluated in 3 settings: a standard clinical reading, a masked expert reading, and a joint reading. The target (lesion)-to-nontarget (normal pancreas) ratio was determined using SUVmax. Image quality was rated by pediatric surgeons in a questionnaire. Results: Fourteen of 19 patients having focal lesions underwent surgery. On the basis of clinical readings, the sensitivity of 68Ga-NODAGA-exendin-4 PET/CT (100%; 95% CI, 77%-100%) was higher than that of 18F-DOPA PET/CT (71%; 95% CI, 42%-92%). Interobserver agreement between readings was higher for 68Ga-NODAGA-exendin-4 than for 18F-DOPA PET/CT (Fleiss k 5 0.91 vs. 0.56). 68Ga-NODAGA-exendin-4 PET/CT provided significantly (P 5 0.021) higher target-to-nontarget ratios (2.02 6 0.65) than did 18F-DOPA PET/CT (1.40 6 0.40). On a 5-point scale, pediatric surgeons rated 68Ga-NODAGA-exendin-4 PET/CT as superior to 18F-DOPA PET/CT. Conclusion: For the detection of focal CHI, 68Ga-NODAGA-exendin-4 PET/CT has higher clinical sensitivity and better interobserver correlation than 18F-DOPA PET/CT. Better contrast and image quality make 68Ga-NODAGA-exendin-4 PET/CT superior to 18F-DOPA PET/CT in surgeons' intraoperative quest for lesion localization.
| Type: | Article |
|---|---|
| Title: | Ga-68-NODAGA-Exendin-4 PET/CT Improves the Detection of Focal Congenital Hyperinsulinism |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.2967/jnumed.121.262327 |
| Publisher version: | https://doi.org/10.2967/jnumed.121.262327 |
| Language: | English |
| Additional information: | © 2022 by the Society of Nuclear Medicine and Molecular Imaging. Immediate Open Access: Creative Commons Attribution 4.0 International License (CC BY) allows users to share and adapt with attribution, excluding materials credited to previous publications. License: https://creativecommons.org/licenses/by/4.0/. Details: http://jnm.snmjournals.org/site/misc/permission.xhtml. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Radiology, Nuclear Medicine & Medical Imaging, congenital hyperinsulinism, focal CHI, diagnostic imaging, Ga-68-NODAGA-exendin-4 PET/CT, F-18-DOPA PET/CT, 11P15 IMPRINTED GENES, DIAGNOSIS, LOCALIZATION, MANAGEMENT, MUTATION, CHILDREN, INFANCY, DIFFUSE, FORMS |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Biology and Cancer Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10179131 |
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