PMID- 32716527
OWN - NLM
STAT- MEDLINE
DCOM- 20210818
LR  - 20210818
IS  - 1365-2265 (Electronic)
IS  - 0300-0664 (Linking)
VI  - 93
IP  - 6
DP  - 2020 Dec
TI  - Exendin-4-based imaging in endogenous hyperinsulinemic hypoglycaemia cohort: A 
      tertiary Endocrine centre experience.
PG  - 678-686
LID - 10.1111/cen.14299 [doi]
AB  - CONTEXT: Insulinoma needs accurate preoperative localization for minimally 
      invasive surgery. Exendin-4-based imaging has shown promising results. OBJECTIVE: 
      To evaluate performance parameters of exendin-4-based imaging in insulinoma 
      localization and compare with other imaging modalities. DESIGN: Retrospective 
      cross-sectional study. PATIENTS: We report 14 patients with endogenous 
      hyperinsulinemic hypoglycaemia (EHH) managed at our centre; in whom, the final 
      diagnosis was insulinoma (n = 11), Munchausen syndrome (MS) (n = 2) and 
      inconclusive (n = 1). Retrospective reporting of CECT, (68) Ga-DOTATATE PET/CT 
      and (68) Ga-NODAGA-exendin-4-PET/CT was done. With per-lesion analysis, 
      performance parameters were calculated for the histopathological diagnosis of 
      insulinoma. MAIN OUTCOME MEASURES: True positive (TP), false positive (FP), false 
      negative (FN), true negative (TN), sensitivity (Sn), specificity (Sp), positive 
      predictive value (PPV), negative predictive value (NPV) for insulinoma 
      localization. RESULTS: In our cohort, 12 histopathologically proven insulinoma 
      lesions [(TP): 11 primary lesions, 1 metastasis] were detected in 11 patients, 
      whereas two patients had MS (TN). Sn and PPV were 75% and 100%, 33.3% and 80% and 
      83.3% and 71.4% for CECT, (68) Ga-DOTATATE PET/CT and (68) 
      Ga-NODAGA-exendin-4-PET/CT, respectively. With exendin-4-based imaging, FP uptake 
      in normal pancreatic tissue and FN results in the pancreatic tail lesion was 
      seen. In one patient, TN result suggested the correct diagnosis of MS. 
      CONCLUSION: (68) Ga-NODAGA-exendin-4-PET/CT has higher sensitivity than (68) 
      Ga-DOTATATE PET/CT and CECT for insulinoma localization. FP uptake in normal 
      pancreas and FN result in tail lesions are limitations of currently utilized 
      exendin-4-based imaging.
CI  - (c) 2020 John Wiley & Sons Ltd.
FAU - Garg, Robin
AU  - Garg R
AD  - Department of Endocrinology, Seth GS Medical College & KEM Hospital, Parel, 
      India.
FAU - Shah, Ravikumar
AU  - Shah R
AD  - Department of Endocrinology, Seth GS Medical College & KEM Hospital, Parel, 
      India.
FAU - Tiwari, Ankita
AU  - Tiwari A
AD  - Department of Endocrinology, Seth GS Medical College & KEM Hospital, Parel, 
      India.
FAU - Purandare, Nilendu
AU  - Purandare N
AD  - Department of Radiodiagnosis and Imaging, Tata Memorial Center, Mumbai, India.
FAU - Lele, Vikram R
AU  - Lele VR
AD  - Department of Nuclear Medicine & PET/CT, Jaslok Hospital & Research Center, 
      Mumbai, India.
FAU - Malhotra, Gaurav
AU  - Malhotra G
AD  - Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Centre, 
      Annexe, India.
FAU - Verma, Priyanka
AU  - Verma P
AD  - Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Centre, 
      Annexe, India.
FAU - Gosavi, Vikrant
AU  - Gosavi V
AD  - Department of Endocrinology, Seth GS Medical College & KEM Hospital, Parel, 
      India.
FAU - Dalvi, Abhay
AU  - Dalvi A
AD  - Department of General Surgery, Seth GS Medical College & KEM Hospital, Parel, 
      India.
FAU - Kumar Jaiswal, Sanjeet
AU  - Kumar Jaiswal S
AD  - Department of Endocrinology, Seth GS Medical College & KEM Hospital, Parel, 
      India.
FAU - Patil, Virendra
AU  - Patil V
AD  - Department of Endocrinology, Seth GS Medical College & KEM Hospital, Parel, 
      India.
FAU - Ramteke-Jadhav, Swati
AU  - Ramteke-Jadhav S
AUID- ORCID: 0000-0003-1251-8918
AD  - Department of Endocrinology, Seth GS Medical College & KEM Hospital, Parel, 
      India.
FAU - Lila, Anurag
AU  - Lila A
AD  - Department of Endocrinology, Seth GS Medical College & KEM Hospital, Parel, 
      India.
FAU - Shah, Nalini
AU  - Shah N
AD  - Department of Endocrinology, Seth GS Medical College & KEM Hospital, Parel, 
      India.
FAU - Bandgar, Tushar
AU  - Bandgar T
AUID- ORCID: 0000-0002-6902-4639
AD  - Department of Endocrinology, Seth GS Medical College & KEM Hospital, Parel, 
      India.
LA  - eng
PT  - Journal Article
DEP - 20200806
PL  - England
TA  - Clin Endocrinol (Oxf)
JT  - Clinical endocrinology
JID - 0346653
RN  - 9P1872D4OL (Exenatide)
SB  - IM
MH  - *Congenital Hyperinsulinism
MH  - Cross-Sectional Studies
MH  - Exenatide
MH  - Humans
MH  - *Insulinoma/diagnostic imaging
MH  - *Pancreatic Neoplasms/diagnostic imaging
MH  - Positron Emission Tomography Computed Tomography
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Exendin-4 PET/CT
OT  - GLP-1 R imaging
OT  - endogenous hyperinsulinemic hypoglycaemia
OT  - insulinoma
EDAT- 2020/07/28 06:00
MHDA- 2021/08/19 06:00
CRDT- 2020/07/28 06:00
PHST- 2020/06/03 00:00 [received]
PHST- 2020/07/08 00:00 [revised]
PHST- 2020/07/12 00:00 [accepted]
PHST- 2020/07/28 06:00 [pubmed]
PHST- 2021/08/19 06:00 [medline]
PHST- 2020/07/28 06:00 [entrez]
AID - 10.1111/cen.14299 [doi]
PST - ppublish
SO  - Clin Endocrinol (Oxf). 2020 Dec;93(6):678-686. doi: 10.1111/cen.14299. Epub 2020 
      Aug 6.