[18F]FB(ePEG12)12-exendin-4 noninvasive imaging of insulinoma negative for insulin immunostaining on specimen from endoscopic ultrasonography-guided fine needle aspiration: a case report with review of literature
Insulinomas are the most common functional pancreatic neuroendocrine neoplasm; when treatment is delayed, they induce hyperinsulinemic hypoglycemia, which is life-threatening. As surgical resection is the only curative treatment for insulinoma, preoperative localization is crucial; however, localiza...
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The Japan Endocrine Society
2024-09-01
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| Series: | Endocrine Journal |
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| Online Access: | https://www.jstage.jst.go.jp/article/endocrj/71/9/71_EJ24-0187/_html/-char/en |
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| author | Daisuke Otani Takaaki Murakami Saeko Murakami Ikuko Hanaoka Hiroyuki Fujimoto Yoichi Shimizu Kanae Kawai Miyake Kentaro Sakaki Yohei Ueda Daisuke Tanaka Tsuyoshi Ohno Hironori Shimizu Naoki Uyama Norishige Iizuka Daisuke Yabe Yuji Nakamoto Nobuya Inagaki |
| author_facet | Daisuke Otani Takaaki Murakami Saeko Murakami Ikuko Hanaoka Hiroyuki Fujimoto Yoichi Shimizu Kanae Kawai Miyake Kentaro Sakaki Yohei Ueda Daisuke Tanaka Tsuyoshi Ohno Hironori Shimizu Naoki Uyama Norishige Iizuka Daisuke Yabe Yuji Nakamoto Nobuya Inagaki |
| author_sort | Daisuke Otani |
| collection | DOAJ |
| description | Insulinomas are the most common functional pancreatic neuroendocrine neoplasm; when treatment is delayed, they induce hyperinsulinemic hypoglycemia, which is life-threatening. As surgical resection is the only curative treatment for insulinoma, preoperative localization is crucial; however, localization based on conventional imaging modalities such as computed tomography (CT) and magnetic resonance imaging is often inconclusive. Somatostatin receptor-targeted imaging is another option for detecting pancreatic neuroendocrine neoplasms but has low sensitivity and is not specific for insulinoma. The clinical application of other localizing approaches such as selective arterial calcium stimulation and endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) is limited by their being invasive and/or technically complex. Moreover, an EUS-FNA specimen of an insulinoma may be negative on insulin immunostaining. Thus, a noninvasive and clinically practical insulinoma-specific diagnostic tool to discriminate insulinomas with high accuracy is anticipated. Glucagon-like peptide-1 receptor (GLP-1R)-targeted imaging has emerged in the effort to fulfill this need. We recently developed the novel fluorine-18-labeled exendin-4-based probe conjugated with polyethylene glycol, [18F]FB(ePEG12)12-exendin-4 (18F-exendin-4) for positron emission tomography (PET) imaging and reported its clinical benefit in a case of insulinoma in the pancreatic tail. We report here a case of insulinoma in the pancreatic head in which an EUS-FNA specimen was negative on insulin immunostaining while precise preoperative localization and conclusive evidence for curative enucleation was provided by 18F-exendin-4 PET/CT (Japan Registry of Clinical Trials; jRCTs051200156). |
| format | Article |
| id | doaj-art-091ae9c05e6244ff986fbdcba5b5d427 |
| institution | Kabale University |
| issn | 1348-4540 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | The Japan Endocrine Society |
| record_format | Article |
| series | Endocrine Journal |
| spelling | doaj-art-091ae9c05e6244ff986fbdcba5b5d4272025-01-22T05:20:12ZengThe Japan Endocrine SocietyEndocrine Journal1348-45402024-09-0171992593310.1507/endocrj.EJ24-0187endocrj[18F]FB(ePEG12)12-exendin-4 noninvasive imaging of insulinoma negative for insulin immunostaining on specimen from endoscopic ultrasonography-guided fine needle aspiration: a case report with review of literatureDaisuke Otani0Takaaki Murakami1Saeko Murakami2Ikuko Hanaoka3Hiroyuki Fujimoto4Yoichi Shimizu5Kanae Kawai Miyake6Kentaro Sakaki7Yohei Ueda8Daisuke Tanaka9Tsuyoshi Ohno10Hironori Shimizu11Naoki Uyama12Norishige Iizuka13Daisuke Yabe14Yuji Nakamoto15Nobuya Inagaki16Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto 606-8507, JapanDepartment of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto 606-8507, JapanDepartment of Metabolism and Endocrinology, Kishiwada City Hospital, Kishiwada 596-8501, JapanDepartment of Metabolism and Endocrinology, Kishiwada City Hospital, Kishiwada 596-8501, JapanRadioisotope Research Center, Agency for Health, Safety and Environment, Kyoto University, Kyoto 606-8501, JapanDepartment of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, JapanDepartment of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, JapanDepartment of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto 606-8507, JapanDepartment of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto 606-8507, JapanDepartment of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto 606-8507, JapanDepartment of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, JapanDepartment of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, JapanDepartment of Surgery, Kishiwada City Hospital, Kishiwada 596-8501, JapanDepartment of Pathology, Kishiwada City Hospital, Kishiwada 596-8501, JapanDepartment of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto 606-8507, JapanDepartment of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, JapanDepartment of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto 606-8507, JapanInsulinomas are the most common functional pancreatic neuroendocrine neoplasm; when treatment is delayed, they induce hyperinsulinemic hypoglycemia, which is life-threatening. As surgical resection is the only curative treatment for insulinoma, preoperative localization is crucial; however, localization based on conventional imaging modalities such as computed tomography (CT) and magnetic resonance imaging is often inconclusive. Somatostatin receptor-targeted imaging is another option for detecting pancreatic neuroendocrine neoplasms but has low sensitivity and is not specific for insulinoma. The clinical application of other localizing approaches such as selective arterial calcium stimulation and endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) is limited by their being invasive and/or technically complex. Moreover, an EUS-FNA specimen of an insulinoma may be negative on insulin immunostaining. Thus, a noninvasive and clinically practical insulinoma-specific diagnostic tool to discriminate insulinomas with high accuracy is anticipated. Glucagon-like peptide-1 receptor (GLP-1R)-targeted imaging has emerged in the effort to fulfill this need. We recently developed the novel fluorine-18-labeled exendin-4-based probe conjugated with polyethylene glycol, [18F]FB(ePEG12)12-exendin-4 (18F-exendin-4) for positron emission tomography (PET) imaging and reported its clinical benefit in a case of insulinoma in the pancreatic tail. We report here a case of insulinoma in the pancreatic head in which an EUS-FNA specimen was negative on insulin immunostaining while precise preoperative localization and conclusive evidence for curative enucleation was provided by 18F-exendin-4 PET/CT (Japan Registry of Clinical Trials; jRCTs051200156).https://www.jstage.jst.go.jp/article/endocrj/71/9/71_EJ24-0187/_html/-char/enexendin-4positron emission tomography (pet)insulinomaglucagon-like peptide-1 receptor (glp-1r)pancreatic β-cell imaging |
| spellingShingle | Daisuke Otani Takaaki Murakami Saeko Murakami Ikuko Hanaoka Hiroyuki Fujimoto Yoichi Shimizu Kanae Kawai Miyake Kentaro Sakaki Yohei Ueda Daisuke Tanaka Tsuyoshi Ohno Hironori Shimizu Naoki Uyama Norishige Iizuka Daisuke Yabe Yuji Nakamoto Nobuya Inagaki [18F]FB(ePEG12)12-exendin-4 noninvasive imaging of insulinoma negative for insulin immunostaining on specimen from endoscopic ultrasonography-guided fine needle aspiration: a case report with review of literature Endocrine Journal exendin-4 positron emission tomography (pet) insulinoma glucagon-like peptide-1 receptor (glp-1r) pancreatic β-cell imaging |
| title | [18F]FB(ePEG12)12-exendin-4 noninvasive imaging of insulinoma negative for insulin immunostaining on specimen from endoscopic ultrasonography-guided fine needle aspiration: a case report with review of literature |
| title_full | [18F]FB(ePEG12)12-exendin-4 noninvasive imaging of insulinoma negative for insulin immunostaining on specimen from endoscopic ultrasonography-guided fine needle aspiration: a case report with review of literature |
| title_fullStr | [18F]FB(ePEG12)12-exendin-4 noninvasive imaging of insulinoma negative for insulin immunostaining on specimen from endoscopic ultrasonography-guided fine needle aspiration: a case report with review of literature |
| title_full_unstemmed | [18F]FB(ePEG12)12-exendin-4 noninvasive imaging of insulinoma negative for insulin immunostaining on specimen from endoscopic ultrasonography-guided fine needle aspiration: a case report with review of literature |
| title_short | [18F]FB(ePEG12)12-exendin-4 noninvasive imaging of insulinoma negative for insulin immunostaining on specimen from endoscopic ultrasonography-guided fine needle aspiration: a case report with review of literature |
| title_sort | 18f fb epeg12 12 exendin 4 noninvasive imaging of insulinoma negative for insulin immunostaining on specimen from endoscopic ultrasonography guided fine needle aspiration a case report with review of literature |
| topic | exendin-4 positron emission tomography (pet) insulinoma glucagon-like peptide-1 receptor (glp-1r) pancreatic β-cell imaging |
| url | https://www.jstage.jst.go.jp/article/endocrj/71/9/71_EJ24-0187/_html/-char/en |
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