胰高血糖素样肽-1受体PET/CT定位诊断胰岛素瘤的技术规范Procedure Guideline of Glucagon-like Peptide- 1 Receptor Positron Emission Tomography/Computed Tomography in Localizing Insulinoma
罗亚平;李方;于淼;邢小平;张太平;赵玉沛;
LUO Ya-ping;LI Fang;YU Miao;XING Xiao-ping;ZHANG Tai-ping;ZHAO Yu-pei;Department of Nuclear Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine;Department of Endocrinology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;Department of General Surgery,Peking Union Medical College Hospital,Chinese
摘要(Abstract):
胰岛素瘤的诊断和手术治疗依赖于准确的影像学检查定位。以胰腺β细胞为靶点的胰高血糖素样肽-1受体(glucagon-like peptide-1 receptor, GLP-1R)是近年来胰岛素瘤影像研究中的亮点,推荐临床推广使用~(68)Ga-exendin-4进行GLP-1R正电子发射断层显像/计算机体层成像(positron emission tomography/computed tomography, PET/CT)来定位诊断胰岛素瘤。本文介绍GLP-1R显像在胰岛素瘤中的应用概况,并以~(68)Ga-exendin-4 GLP-1R PET/CT显像为例,介绍该技术的操作规范,以期为临床提供借鉴。
The diagnosis and surgical treatment of insulinoma is dependent on accurate localization with imaging modalities. Glucagon-like peptide-1 receptor(GLP-1 R) imaging that targets pancreatic β cells has been highlighted for detecting insulinomas in recent years. Since the high sensitivity and specificity(se. 99%, sp. 100%) of GLP-1 R imaging in localizing insulinoma, GLP-1 R positron emission tomography/computed tomography(PET/CT) with ~(68)Ga-exendin-4 is recommended to be introduced into clinical practice. This paper introduced the application of GLP-1 R imaging in insulinoma, and took the GLP-1 R PET/CT with ~(68)Ga-exendin-4 as an example to elaborate the operation standard of this technique, aiming to provide a reference for clinical practice.
关键词(KeyWords):
胰高血糖素样肽-1受体;~(68)Ga-exendin-4;胰岛素瘤;技术
glucagon-like peptide-1 receptor;68Ga-exendin-4;insulinoma;technology
基金项目(Foundation): 国家自然科学基金(81501515);; 公益性行业科研专项(201402001)
作者(Author):
罗亚平;李方;于淼;邢小平;张太平;赵玉沛;
LUO Ya-ping;LI Fang;YU Miao;XING Xiao-ping;ZHANG Tai-ping;ZHAO Yu-pei;Department of Nuclear Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine;Department of Endocrinology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences &Peking Union Medical College;Department of General Surgery,Peking Union Medical College Hospital,Chinese
Email:
DOI:
参考文献(References):
- [1] Grant CS.Insulinoma[J].Best Pract Res Clin Gastroenterol,2005,19:783- 798.
- [2] Fidler JL,Fletcher JG,Reading CC,et al.Preoperative detection of pancreatic insulinomas on multiphasic helical CT[J].AJR Am J Roentgenol,2003,181:775- 780.
- [3] Sundin A,Arnold R,Baudin E,et al.ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors:Radiological,Nuclear Medicine & Hybrid Imaging[J].Neuroendocrinology,2017,105:212- 244.
- [4] Rostambeigi N,Thompson GB.What should be done in an operating room when an insulinoma cannot be found?[J].Clin Endocrinol (Oxf),2009,70:512- 515.
- [5] Sotoudehmanesh R,Hedayat A,Shirazian N,et al.Endoscopic ultrasonography (EUS) in the localization of insulinoma[J].Endocrine,2007,31:238- 241.
- [6] Korner M,Stockli M,Waser B,et al.GLP- 1 receptor expression in human tumors and human normal tissues:potential for in vivo targeting[J].J Nucl Med,2007,48:736- 743.
- [7] Heller RS,Aponte GW.Intra-islet regulation of hormone secretion by glucagon-like peptide- 1-(7-36) amide[J].Am J Physiol,1995,269:G852- 860.
- [8] Heller RS,Kieffer TJ,Habener JF.Insulinotropic glucagon-like peptide I receptor expression in glucagon-producing alpha-cells of the rat endocrine pancreas[J].Diabetes,1997,46:785- 791.
- [9] Tornehave D,Kristensen P,Romer J,et al.Expression of the GLP- 1 receptor in mouse,rat,and human pancreas[J].J Histochem Cytochem,2008,56:841- 851.
- [10] Korner M,Christ E,Wild D,et al.Glucagon-like peptide- 1 receptor overexpression in cancer and its impact on clinical applications[J].Front Endocrinol (Lausanne),2012,3:158.
- [11] Doyle ME,Egan JM.Mechanisms of action of glucagon-like peptide 1 in the pancreas[J].Pharmacol Ther,2007,113:546- 593.
- [12] Pauly RP,Demuth HU,Rosche F,et al.Improved glucose tolerance in rats treated with the dipeptidyl peptidase IV (CD26) inhibitor Ile-thiazolidide[J].Metabolism,1999,48:385- 389.
- [13] Eng J,Kleinman WA,Singh L,et al.Isolation and characterization of exendin- 4,an exendin- 3 analogue,from Heloderma suspectum venom.Further evidence for an exendin receptor on dispersed acini from guinea pig pancreas[J].J Biol Chem,1992,267:7402- 7405.
- [14] Wild D,Wicki A,Mansi R,et al.Exendin- 4-based radiopharmaceuticals for glucagonlike peptide- 1 receptor PET/CT and SPECT/CT[J].J Nucl Med,2010,51:1059- 1067.
- [15] Wild D,Behe M,Wicki A,et al.[Lys40(Ahx-DTPA- 111In)NH2]exendin- 4,a very promising ligand for glucagon-like peptide- 1 (GLP- 1) receptor targeting[J].J Nucl Med,2006,47:2025- 2033.
- [16] Brom M,Joosten L,Oyen WJ,et al.Radiolabelled GLP- 1 analogues for in vivo targeting of insulinomas[J].Contrast Media Mol Imaging,2012,7:160- 166.
- [17] Wicki A,Wild D,Storch D,et al.[Lys40(Ahx-DTPA- 111In)NH2]-Exendin- 4 is a highly efficient radiotherapeutic for glucagon-like peptide- 1 receptor-targeted therapy for insulinoma[J].Clin Cancer Res,2007,13:3696- 3705.
- [18] Jodal A,Lankat-Buttgereit B,Brom M,et al.A comparison of three (67/68)Ga-labelled exendin- 4 derivatives for beta-cell imaging on the GLP- 1 receptor:the influence of the conjugation site of NODAGA as chelator[J].EJNMMI Res,2014,4:31.
- [19] Gotthardt M,Fischer M,Naeher I,et al.Use of the incretin hormone glucagon-like peptide- 1 (GLP- 1) for the detection of insulinomas:initial experimental results[J].Eur J Nucl Med Mol Imaging,2002,29:597- 606.
- [20] Brom M,Oyen WJ,Joosten L,et al.68Ga-labelled exendin- 3,a new agent for the detection of insulinomas with PET[J].Eur J Nucl Med Mol Imaging,2010,37:1345- 1355.
- [21] Kiesewetter DO,Guo N,Guo J,et al.Evaluation of an [(18)F]AlF-NOTA Analog of Exendin- 4 for Imaging of GLP- 1 Receptor in Insulinoma[J].Theranostics,2012,2:999- 1009.
- [22] Wu Z,Todorov I,Li L,et al.In vivo imaging of transplanted islets with 64Cu-DO3A-VS-Cys40-Exendin- 4 by targeting GLP- 1 receptor[J].Bioconjug Chem,2011,22:1587- 1594.
- [23] Wu Z,Liu S,Hassink M,et al.Development and evaluation of 18F-TTCO-Cys40-Exendin- 4:a PET probe for imaging transplanted islets[J].J Nucl Med,2013,54:244- 251.
- [24] Selvaraju RK,Velikyan I,Asplund V,et al.Pre-clinical evaluation of [(68)Ga]Ga-DO3A-VS-Cys(40)-Exendin- 4 for imaging of insulinoma[J].Nucl Med Biol,2014,41:471- 476.
- [25] Wild D,Macke H,Christ E,et al.Glucagon-like peptide 1- receptor scans to localize occult insulinomas[J].N Engl J Med,2008,359:766- 768.
- [26] Christ E,Wild D,Forrer F,et al.Glucagon-like peptide- 1 receptor imaging for localization of insulinomas[J].J Clin Endocrinol Metab,2009,94:4398- 4405.
- [27] Christ E,Wild D,Ederer S,et al.Glucagon-like peptide- 1 receptor imaging for the localisation of insulinomas:a prospective multicentre imaging study[J].Lancet Diabetes Endocrinol,2013,1:115- 122.
- [28] Sowa-Staszczak A,Pach D,Mikolajczak R,et al.Glucagon-like peptide- 1 receptor imaging with [Lys40(Ahx-HYNIC- 99mTc/EDDA)NH2]-exendin- 4 for the detection of insulinoma[J].Eur J Nucl Med Mol Imaging,2013,40:524- 531.
- [29] Antwi K,Fani M,Nicolas G,et al.Localization of Hidden Insulinomas with 68Ga-DOTA-Exendin- 4 PET/CT:A Pilot Study[J].J Nucl Med,2015,56:1075- 1078.
- [30] Luo Y,Yu M,Pan Q,et al.(68)Ga-NOTA-exendin- 4 PET/CT in detection of occult insulinoma and evaluation of physiological uptake[J].Eur J Nucl Med Mol Imaging,2015,42:531- 532.
- [31] Luo Y,Li N,Kiesewetter DO,et al.68Ga-NOTA-Exendin- 4 PET/CT in Localization of an Occult Insulinoma and Appearance of Coexisting Esophageal Carcinoma[J].Clin Nucl Med,2016,41:341- 343.
- [32] Luo Y,Pan Q,Yao S,et al.Glucagon-Like Peptide- 1 Receptor PET/CT with 68Ga-NOTA-Exendin- 4 for Detecting Localized Insulinoma:A Prospective Cohort Study[J].J Nucl Med,2016,57:715- 720.
- [33] Luo Y,Li J,Yang A,et al.68Ga-Exendin- 4 PET/CT in Evaluation of Endoscopic Ultrasound-Guided Ethanol Abla-tion of an Insulinoma[J].Clin Nucl Med,2017,42:310- 311.
- [34] 罗亚平,潘青青,要少波,等.68Ga-exendin- 4 PET/CT显像定位诊断胰岛素瘤[J].中华核医学与分子影像杂志,2017,37:137- 141.
- [35] Vegt E,Melis M,Eek A,et al.Renal uptake of different radiolabelled peptides is mediated by megalin:SPECT and biodistribution studies in megalin-deficient mice[J].Eur J Nucl Med Mol Imaging,2011,38:623- 632.
- [36] Selvaraju RK,Bulenga TN,Espes D,et al.Dosimetry of [(68)Ga]Ga-DO3A-VS-Cys(40)-Exendin- 4 in rodents,pigs,non-human primates and human-repeated scanning in human is possible[J].Am J Nucl Med Mol Imaging,2015,5:259- 269.
- 胰高血糖素样肽-1受体
- ~(68)Ga-exendin-4
- 胰岛素瘤
- 技术
glucagon-like peptide-1 receptor - 68Ga-exendin-4
- insulinoma
- technology
- 罗亚平
- 李方
- 于淼
- 邢小平
- 张太平
- 赵玉沛
LUO Ya-ping- LI Fang
- YU Miao
- XING Xiao-ping
- ZHANG Tai-ping
- ZHAO Yu-pei
- Department of Nuclear Medicine
- Peking Union Medical College Hospital
- Chinese Academy of Medical Sciences &Peking Union Medical College
- Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine
- Department of Endocrinology
- Peking Union Medical College Hospital
- Chinese Academy of Medical Sciences &Peking Union Medical College
- Department of General Surgery
- Peking Union Medical College Hospital
- Chinese
- 罗亚平
- 李方
- 于淼
- 邢小平
- 张太平
- 赵玉沛
LUO Ya-ping- LI Fang
- YU Miao
- XING Xiao-ping
- ZHANG Tai-ping
- ZHAO Yu-pei
- Department of Nuclear Medicine
- Peking Union Medical College Hospital
- Chinese Academy of Medical Sciences &Peking Union Medical College
- Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine
- Department of Endocrinology
- Peking Union Medical College Hospital
- Chinese Academy of Medical Sciences &Peking Union Medical College
- Department of General Surgery
- Peking Union Medical College Hospital
- Chinese