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68Ga-Exendin-4 PET/CT Differentiates Insulinoma From Accessory Spleen in a Patient Presenting Indeterminate MRI and 68Ga-DOTATATE PET/CT Findings.
Clin Nucl Med · 2022
Last updated 2026-05-28A 55-year-old woman with severe low blood sugar was suspected of having an insulinoma, a tumor causing excess insulin. MRI and a PET/CT scan using 68Ga-DOTATATE showed a nodule with high activity, similar to the spleen, leaving uncertainty about whether it was an insulinoma or an accessory spleen. A follow-up PET/CT scan using 68Ga-exendin-4 showed high activity in the nodule but not in the spleen, confirming the insulinoma and ruling out the accessory spleen diagnosis.
AI summary of the abstract below.
| Journal | Clin Nucl Med, 2022 |
|---|---|
| Citations | 3 |
| Relative citation ratio | 0.43 |
| NIH percentile | 26 |
| Molecules | — |
Abstract
A 55-year-old woman with endogenous hyperinsulinemia hypoglycemia was clinically diagnosed with insulinoma. Contrast-enhanced MRI revealed an inconclusive hypointense lesion in the pancreatic tail, and the enhancement pattern does not support the diagnosis of insulinoma. 68Ga-DOTATATE PET/CT showed intense radioactivity in this nodule, similar to the radioactivity of the adjacent spleen. Therefore, the diagnosis of accessory spleen cannot be excluded. Follow-up with 68Ga-exendin-4 PET/CT also showed intense uptake in this nodule, but no significant uptake in the spleen was observed at this time. Therefore, the insulinoma was unmasked from the spleen, excluding the diagnosis of accessory spleen, and allowing curative surgery.
Verbatim abstract via PubMed 34507334 ↗