|
1
|
Xu Q, Zhu C, Xu Y, Pan D, Liu P, Yang R, Wang L, Chen F, Sun X, Luo S, Yang M. Preliminary evaluation of [18F]AlF-NOTA-MAL-Cys39-exendin-4 in insulinoma with PET. J Drug Target 2015; 23:813-20. [PMID: 25758750 DOI: 10.3109/1061186x.2015.1020808] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND High expression of glucagon-like peptide-1 receptor (GLP-1R) in insulinoma supplies a potential drug target for tumor imaging. Exendin-4 can specifically bind to GLP-1R as an agonist and its analogs are extensively used in receptor imaging studies. PURPOSE A new GLP-1R imaging agent, [(18)F]AlF-NOTA-MAL-Cys(39)-exendin-4, was designed and prepared for insulinoma imaging. METHODS Cys(39)-exendin-4 was conjugated with NOTA-MAL, then the compound was radiolabeled with [(18)F]AlF complex to obtained [(18)F]AlF-NOTA-MAL-Cys(39)-exendin-4. The tumor-targeting characters of the tracer were evaluated in INS-1 cells and BALB/c nude mice models. RESULTS [(18)F]AlF-NOTA-MAL-Cys(39)-exendin-4 can be efficiently produced with a yield of 17.5 ± 3.2% (non-decay corrected) and radiochemical purity of >95%. The IC50 value of displacement [(18)F]AlF-NOTA-MAL-Cys(39)-exendin-4 with Cys(39)-exendin-4 was 13.52 ± 1.36 nM. PET images showed excellent tumor visualization with high uptake (9.15 ± 1.6%ID/g at 30 min and 7.74 ± 0.87%ID/g at 60 min). The tumor to muscle, pancreas and liver ratios were 63.25, 3.85 and 7.29 at 60 min after injection. GLP-1R binding specificity was demonstrated by co-injection with an excess of unlabeled Cys(39)-exendin-4 and the tumor uptake was found to be reduced significantly. CONCLUSION [(18)F]AlF-NOTA-MAL-Cys(39)-exendin-4 shows favorable characteristics for insulinoma imaging and may be translated to clinical studies.
Collapse
Affiliation(s)
- Qing Xu
- a Department of Radiation Oncology , The First Affiliated Hospital of Nanjing Medical University , Nanjing , China
| | - Chen Zhu
- a Department of Radiation Oncology , The First Affiliated Hospital of Nanjing Medical University , Nanjing , China
| | - Yuping Xu
- b Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine , Jiangsu Institute of Nuclear Medicine , Wuxi , China , and
| | - Donghui Pan
- b Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine , Jiangsu Institute of Nuclear Medicine , Wuxi , China , and
| | - Ping Liu
- c School of Pharmaceutical Science, Zhengzhou University , Zhengzhou , China
| | - Runlin Yang
- b Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine , Jiangsu Institute of Nuclear Medicine , Wuxi , China , and
| | - Lizhen Wang
- b Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine , Jiangsu Institute of Nuclear Medicine , Wuxi , China , and
| | - Fei Chen
- b Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine , Jiangsu Institute of Nuclear Medicine , Wuxi , China , and
| | - Xinchen Sun
- a Department of Radiation Oncology , The First Affiliated Hospital of Nanjing Medical University , Nanjing , China
| | - Shineng Luo
- a Department of Radiation Oncology , The First Affiliated Hospital of Nanjing Medical University , Nanjing , China .,b Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine , Jiangsu Institute of Nuclear Medicine , Wuxi , China , and
| | - Min Yang
- a Department of Radiation Oncology , The First Affiliated Hospital of Nanjing Medical University , Nanjing , China .,b Key Laboratory of Nuclear Medicine, Ministry of Health, Jiangsu Key Laboratory of Molecular Nuclear Medicine , Jiangsu Institute of Nuclear Medicine , Wuxi , China , and
| |
Collapse
|
|
3
|
Sowa-Staszczak A, Pach D, Mikołajczak R, Mäcke H, Jabrocka-Hybel A, Stefańska A, Tomaszuk M, Janota B, Gilis-Januszewska A, Małecki M, Kamiński G, Kowalska A, Kulig J, Matyja A, Osuch C, Hubalewska-Dydejczyk A. Glucagon-like peptide-1 receptor imaging with [Lys40(Ahx-HYNIC- 99mTc/EDDA)NH2]-exendin-4 for the detection of insulinoma. Eur J Nucl Med Mol Imaging 2012; 40:524-31. [PMID: 23224740 PMCID: PMC3590421 DOI: 10.1007/s00259-012-2299-1] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 11/06/2012] [Indexed: 02/07/2023]
Abstract
PURPOSE The objective of this article is to present a new method for the diagnosis of insulinoma with the use of [Lys(40)(Ahx-HYNIC-(99m)Tc/EDDA)NH2]-exendin-4. METHODS Studies were performed in 11 patients with negative results of all available non-isotopic diagnostic methods (8 with symptoms of insulinoma, 2 with malignant insulinoma and 1 with nesidioblastosis). In all patients glucagon-like peptide-1 (GLP-1) receptor imaging (whole-body and single photon emission computed tomography/CT examinations) after the injection of 740 MBq of the tracer was performed. RESULTS Both sensitivity and specificity of GLP-1 receptor imaging were assessed to be 100 % in patients with benign insulinoma. In all eight cases with suspicion of insulinoma a focal uptake in the pancreas was found. In six patients surgical excision of the tumour was performed (type G1 tumours were confirmed histopathologically). In one patient surgical treatment is planned. One patient was disqualified from surgery. In one case with malignant insulinoma pathological accumulation of the tracer was found only in the region of local recurrence. The GLP-1 study was negative in the other malignant insulinoma patient. In one case with suspicion of nesidioblastosis, a focal accumulation of the tracer was observed and histopathology revealed coexistence of insulinoma and nesidioblastosis. CONCLUSION [Lys(40)(Ahx-HYNIC-(99m)Tc/EDDA)NH2]-exendin-4 seems to be a promising diagnostic tool in the localization of small insulinoma tumours, but requires verification in a larger series of patients.
Collapse
Affiliation(s)
- Anna Sowa-Staszczak
- Department of Endocrinology, Jagiellonian University Medical College, Kopernika 17, 31-501 Cracow, Poland
| | - Dorota Pach
- Department of Endocrinology, Jagiellonian University Medical College, Kopernika 17, 31-501 Cracow, Poland
| | - Renata Mikołajczak
- Radioisotope Center POLATOM, National Centre for Nuclear Research, Otwock, Poland
| | - Helmut Mäcke
- Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany
| | - Agata Jabrocka-Hybel
- Department of Endocrinology, Jagiellonian University Medical College, Kopernika 17, 31-501 Cracow, Poland
| | - Agnieszka Stefańska
- Department of Endocrinology, Jagiellonian University Medical College, Kopernika 17, 31-501 Cracow, Poland
| | - Monika Tomaszuk
- Department of Endocrinology, Jagiellonian University Medical College, Kopernika 17, 31-501 Cracow, Poland
| | - Barbara Janota
- Radioisotope Center POLATOM, National Centre for Nuclear Research, Otwock, Poland
| | | | - Maciej Małecki
- Department of Metabolic Diseases, Jagiellonian University Medical College, Cracow, Poland
| | - Grzegorz Kamiński
- Department of Endocrinology and Radioisotopic Therapy, Military Institute of Medicine, Warsaw, Poland
| | - Aldona Kowalska
- Department of Endocrinology and Nuclear Medicine, Holycross Cancer Center, Kielce, Poland
| | - Jan Kulig
- Department of General, Oncological and Gastroenterological Surgery, Jagiellonian University Medical College, Cracow, Poland
| | - Andrzej Matyja
- Department of General, Oncological and Gastroenterological Surgery, Jagiellonian University Medical College, Cracow, Poland
| | - Czesław Osuch
- Department of General, Oncological and Gastroenterological Surgery, Jagiellonian University Medical College, Cracow, Poland
| | | |
Collapse
|
|
4
|
Abstract
Pancreatic endocrine tumors (PETs) are uncommon and have an incidence of approximately 4-5 per 1 000 000 people, accounting for 1%-2% of all pancreatic neoplasms. They usually grow slowly, eventually metastasize and lead to death. PETs can be classified as functioning or non-functioning tumors based on clinical manifestation. The pathogenesis of PETs may involve abnormal expression of CD10, CD44, CD99, p27, COX2, Ki-67, KIT, CK19, ARHI, RUNX1T1, and survivin genes, loss of heterozygosity on chromosomes, hypermethylation of tumor suppressor genes, and overexpression of ghrelin. Chromogranin A (CgA) has long been used as an important broad-spectrum marker for the identification of PETs. KIT and endoglin are new independent prognostic markers for PETs. The diagnosis is based on histopathology demonstrating neuroendocrine features such as positive staining for chromogranin A and specific hormones such as gastrin, proinsulin, vasoactive intestinal peptide (VIP) and glucagon. In addition to standard localization procedures, radiology diagnosis including computed tomography (CT), positron emission tomography and computed tomography (PET/CT), magnetic resonance imaging (MRI), ultrasound (US), endoscopic ultrasound (EUS), laparoscopic ultrasound (LUS), dynamic enhanced spiral CT, selective arterial stimulation and venous sampling (ASVS), and somatostatin receptor scintigraphy (SRS) are performed. Surgery is still one of the cornerstones in the management of PETs. Laparoscopy, and drugs of somatostatin analogs are routinely used. Understanding of the recent advances of PETs has important implications for the early diagnosis and treatment of PETs.
Collapse
|