Innovative imaging of insulinoma: the end of sampling? A review.
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Christ E
Division of Endocrinology, Diabetology and Metabolism, University Hospital of Basel, University of Basel, Basel, Switzerland.
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Antwi K
Clinic of Radiology and Nuclear Medicine, University Hospital, Basel, Switzerland.
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Fani M
Clinic of Radiology and Nuclear Medicine, University Hospital, Basel, Switzerland.
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Wild D
Center for Neuroendocrine and Endocrine Tumors, University Hospital Basel, Basel Switzerland.
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Published in:
- Endocrine-related cancer. - 2020
English
Receptors for the incretin glucagon-like peptide-1 (GLP-1R) have been found overexpressed in selected types of human tumors and may, therefore, play an increasingly important role in endocrine gastrointestinal tumor management. In particular, virtually all benign insulinomas express GLP-1R in high density. Targeting GLP-1R with indium-111, technetium-99m or gallium-68-labeled exendin-4 offers a new approach that permits the successful localization of small benign insulinomas. It is likely that this new non-invasive technique has the potential to replace the invasive localization of insulinomas by selective arterial stimulation and venous sampling. In contrast to benign insulinomas, malignant insulin-secreting neuroendocrine tumors express GLP-1R in only one-third of the cases, while they more often express the somatostatin subtype 2 receptors. Importantly, one of the two receptors appears to be always overexpressed. In special cases of endogenous hyperinsulinemic hypoglycemia (EHH), that is, in the context of MEN-1 or adult nesidioblastosis GLP-1R imaging is useful whereas in postprandial hypoglycemia in the context of bariatric surgery, GLP-1R imaging is probably not helpful. This review focuses on the potential use of GLP-1R imaging in the differential diagnosis of EHH.
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Language
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Open access status
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green
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Persistent URL
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https://sonar.ch/global/documents/2260
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