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J Clin Endocrinol Metab. 2017 Jan 1;102(1):195-199. doi: 10.1210/jc.2016-3445.

Localization of Insulinoma Using 68Ga-DOTATATE PET/CT Scan.

Author information

1
Endocrine Oncology Branch, National Cancer Institute.
2
Positron Emission Tomography Department, Clinical Center, and.
3
Thoracic and Endocrine Surgery, University Hospitals of Geneva, Geneva, Switzerland 1211.
4
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland 20892; and.

Abstract

Context:

Reliable localization of insulinoma is critical for successful treatment.

Objective:

This study compared the accuracy of 68Gallium DOTA-(Tyr3)-octreotate (Ga-DOTATATE) positron emission tomography (PET)/computed tomography (CT) to anatomic imaging modalities, selective arterial secretagogue injection (SASI), and intraoperative ultrasound (IO ultrasound) and palpation for localizing insulinoma in patients who were biochemically cured.

Design, Setting, and Patients:

We conducted a retrospective analysis of 31 patients who had an insulinoma. The results of CT, magnetic resonance imaging (MRI), ultrasound, IO ultrasound, 68Ga-DOTATATE PET/CT, SASI, and operative findings were analyzed.

Intervention, Main Outcome Measures, and Results:

The insulinomas were correctly localized in 17 out of 31 (55%) patients by CT, in 17 out of 28 (61%) by MRI, in 6 out of 28 (21%) by ultrasound, and in 9 out of 10 (90%) by 68Ga-DOTATATE. In 29 of 31 patients (93.5%) who had IO ultrasound, an insulinoma was successfully localized. Thirty patients underwent SASI, and the insulinoma was regionalized in 28 out of 30 patients (93%). In 19 out of 23 patients (83%), manual palpation identified insulinoma. In patients who had all 4 noninvasive imaging studies, CT was concordant with 68Ga-DOTATATE in 6 out of 9 patients (67%), MRI in 8 out of 9 (78%), ultrasound in 0 out of 9; the lesion was only seen by 68Ga-DOTATATE in 1 out of 9 (11%).

Conclusions:

68Ga-DOTATATE PET/CT identifies most insulinomas and may be considered as an adjunct imaging study when all imaging studies are negative and when a minimally invasive surgical approach is planned.

PMID:
27805844
PMCID:
PMC6083884
DOI:
10.1210/jc.2016-3445
[Indexed for MEDLINE]
Free PMC Article

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