{"entity": "publication", "iuid": "c5f14ccfc2a84ecea6a47d1b9de8afe4", "timestamp": "2026-08-23T09:24:56.443Z", "links": {"self": {"href": "https://publications-affiliated.scilifelab.se/publication/c5f14ccfc2a84ecea6a47d1b9de8afe4.json"}, "display": {"href": "https://publications-affiliated.scilifelab.se/publication/c5f14ccfc2a84ecea6a47d1b9de8afe4"}}, "title": "Improved Localization of Insulinomas Using 68Ga-NODAGA-Exendin-4 PET/CT.", "authors": [{"family": "Boss", "given": "Marti", "initials": "M"}, {"family": "Eriksson", "given": "Olof", "initials": "O"}, {"family": "Mikkola", "given": "Kirsi", "initials": "K"}, {"family": "Eek", "given": "Annemarie", "initials": "A"}, {"family": "Brom", "given": "Maarten", "initials": "M"}, {"family": "Buitinga", "given": "Mijke", "initials": "M"}, {"family": "Brouwers", "given": "Adrienne H", "initials": "AH"}, {"family": "Velikyan", "given": "Irina", "initials": "I"}, {"family": "Waser", "given": "Beatrice", "initials": "B"}, {"family": "Kauhanen", "given": "Saila", "initials": "S"}, {"family": "Solin", "given": "Olof", "initials": "O"}, {"family": "Marciniak", "given": "Camille", "initials": "C"}, {"family": "Eriksson", "given": "Barbro", "initials": "B"}, {"family": "Reubi", "given": "Jean-Claude", "initials": "JC"}, {"family": "Aveline", "given": "Cyrielle", "initials": "C"}, {"family": "Wild", "given": "Damian", "initials": "D"}, {"family": "Pattou", "given": "Francois", "initials": "F"}, {"family": "Talbot", "given": "Jean-Noel", "initials": "JN"}, {"family": "Hofland", "given": "Johannes", "initials": "J"}, {"family": "Sundin", "given": "Anders", "initials": "A"}, {"family": "Nuutila", "given": "Pirjo", "initials": "P"}, {"family": "Hermans", "given": "John", "initials": "J"}, {"family": "Gotthardt", "given": "Martin", "initials": "M"}], "type": "journal article", "published": "2024-12-03", "journal": {"title": "Journal of nuclear medicine : official publication, Society of Nuclear Medicine", "issn": "1535-5667", "volume": "65", "issue": "12", "pages": "1959-1964", "issn-l": "0161-5505"}, "abstract": "Precise anatomic localization of insulinomas is crucial for surgical treatment. Current routine noninvasive imaging techniques, including CT, MRI, and 68Ga-DOTA-somatostatin analog (DOTA-SSA) PET/CT, have limited sensitivity. Endoscopic ultrasound is highly sensitive but invasive. In this prospective multicenter study, we compared the diagnostic accuracy of 68Ga-NODAGA-exendin-4 (exendin) PET/CT with all routine imaging procedures for the localization of insulinomas. Methods: Sixty-nine adults with biochemically proven adult endogenous hyperinsulinemic hypoglycemia underwent exendin PET/CT and current routine imaging. Images were evaluated in a clinical reading and in an expert reading. Image quality was determined by quantitative analysis. Results: Based on clinical readings, the accuracy of exendin PET/CT (94.4%; 95% CI, 84.6%-98.8%) was greater than that of DOTA-SSA PET/CT (64.8%; 95% CI, 50.6%-77.3%), contrast-enhanced CT/contrast-enhanced diffusion-weighted imaging-MRI (83.3%; 95% CI, 70.7%-92.1%), and endoscopic ultrasound (82.8%; 95% CI, 64.1%-94.1%). In 13% of patients, a correct diagnosis was only reached after exendin PET/CT. Interobserver agreement between readings was higher for exendin PET/CT than for DOTA-SSA PET/CT and contrast-enhanced CT/contrast-enhanced diffusion-weighted imaging-MRI (Cohen \u03ba, 1.0 vs. 0.5 and 0.55). Exendin PET/CT provided a higher insulinoma-to-background ratio (15.3 \u00b1 6.7 vs. 5.2 \u00b1 3.0) and contrast-to-noise ratio (22.6 \u00b1 11.1 vs. 5.1 \u00b1 3.7) than did DOTA-SSA PET/CT. Conclusion: This study demonstrates the superiority of exendin PET/CT in a unique prospective comparison to all current routine imaging modalities for preoperative localization of benign insulinomas, providing the level of evidence needed for clinical implementation.", "doi": "10.2967/jnumed.124.268158", "pmid": "39419553", "labels": [], "xrefs": [{"db": "pmc", "key": "PMC11619583"}, {"db": "pii", "key": "jnumed.124.268158"}], "notes": [], "created": "2026-08-20T13:04:09.287Z", "modified": "2026-08-20T13:04:09.340Z"}