The Physiology of Glucagon-like-peptide-1 Receptor Expression in Patients With Endogenous Hyperinsulinism - Correlation With Histopathology
Insulinomas arise from pancreatic cells and are the most frequent hormone-active tumours of
the pancreas. Insulinomas produce insulin and can become life threatening if they cannot be
localised and removed surgically. Complete tumour resection cures most patients, hence
surgery is the treatment of choice for begin and malignant insulinomas. The potential for
surgical cure necessitates accurate tumour localisation before surgery because preoperative
imaging facilitates the detection of small localised, multiple and metastatic insulinomas.
However, the successful localisation of insulinomas is an challenging problem since
approximately 30% of insulinomas cannot be visualised radiographically.
A novel nuclear medicine scanning method using radioactive exendin-4 (111In-exendin-4) has
recently been developed for imaging of insulinomas. 111In-exendin-4 accumulates specifically
in insulinoma cells via the glucagon-like peptide-1 (GLP-1) receptor. The accumulation of
111In-exendin-4 can be visualised by the use of a special camera (Single Photon Emission
Computed Tomography (SPECT) camera) that detects radioactivity and lights up tumours as hot
The decision to perform surgery is independent of this study. If surgery is performed a
small sample of the tumor will be used for identifying the sites where 111In-exendin-4 binds
to the tumor.
Observational Model: Case-Only, Time Perspective: Prospective
Detection of insulinomas, cure rate
Damian Wild, MD
University Hospital, Basel, Switzerland
Switzerland: Federal Office of Public Health