Table 2.
Overview of clinical single‐photon emission computed tomography (SPECT) tracers and study outcomes
| Author + Year | Compound | Patients | Peptide Dose | Activity Dose | Results | Adverse Events |
|---|---|---|---|---|---|---|
| Indium‐111 | ||||||
| Christ et al. 2009 | [Lys40(AHX‐DOTA‐[In111]In)NH2]exendin‐4 | 6 | 30 μg | 82‐97 MBq | In all six patients, the insulinoma was correctly localized. |
‐ Decrease in blood glucose levels 0.3‐2.4 mmol/L, glucose infusion needed in three patients ‐ Vomiting (n = 1) |
| Wild et al. 2011 | [Lys40(AHX‐DTPA‐[In111]In)NH2]exendin‐4 | 11 | 10 ± 2 μg | 108‐136 MBq | Uptake in four patients was observed with malignant insulinomas that were expressing the GLP‐1R. | ‐ Decrease in blood glucose levels 1.1‐3.3 mmol/L in GLP‐1R–positive patients, 0.5‐0.6 mmol/L in GLP‐1R–negative patients |
| Christ et al. 2013 | [Lys40(AHX‐DTPA‐[In111]In)NH2]exendin‐4 | 30 | 8‐14 μg | 80‐128 MBq |
95% (75‐100) sensitivity 20% (2‐64) specificity 83% (62‐94) positive predictive value |
‐ Decrease in blood glucose levels 0‐2.6 mmol/L, glucose infusion needed in 20 patients |
| Antwi et al. 2015 | [Nle14, Lys40(Ahx‐DOTA‐[111In]In)NH2]exendin‐4] | 5 | 10.5‐14.4 μg | 79.2 ± 9.3 MBq (66‐90 MBq) | In four out of five patients that had surgery, an insulinoma was found in two of four patients. |
‐ Prophylactic glucose infusion was given before the injection ‐ Nausea (n = 2) and vomiting (n = 2) |
| Antwi et al. 2018 | [111In]In‐DOTA‐exendin‐4 | 52 | 11.0‐16.9 μg | 87.5 ± 10.7 MBq (52‐111 MBq) | Sensitivity 68.5% (59.0‐77.0) |
‐ No hypoglycemia due to continuous infusion of glucose ‐ Nausea (n = 27) and vomiting (n = 23) |
| Fluorine‐18 | ||||||
| Sowa‐Staszczak et al. 2013 | [Lys40(Ahx‐HYNIC‐[99mTc]Tc/EDDA)NH2]‐exendin‐4 | 11 | – | 740 MBq (mean) | Focal uptake in all eight cases with suspicion of benign insulinomas was observed. In six of the eight patients, surgery was performed and the presence of an insulinoma was confirmed. | ‐ Most patients with benign insulinoma needed glucose infusion |
| Sowa‐Staszczak et al. 2016 | [Lys40(Ahx‐HYNIC‐[99mTc]Tc/EDDA)NH2]‐exendin‐4 | 40 | – | 740 MBq (mean) | Uptake was seen in 28 patients. In 18 out of 28 cases, insulinomas were identified histopathologically. | ‐ All patients with suspected benign insulinoma needed glucose infusion |