Nuklearmedizin 2019; 58(02): 163
DOI: 10.1055/s-0039-1683646
Poster
PET und SPECT: Onkologie
Georg Thieme Verlag KG Stuttgart · New York

Assessment of intrahepatic islet of Langerhans transplantation with dynamic Ga-68-NODAGA-exendin PET imaging

T Jansen
1   Radboudumc, Radiology and Nuclear Medicine, Nijmegen
,
M Buitinga
1   Radboudumc, Radiology and Nuclear Medicine, Nijmegen
,
M Boss
1   Radboudumc, Radiology and Nuclear Medicine, Nijmegen
,
E de Koning
2   Leiden University Medical Center, Internal Medicine, Leiden
,
M Engelse
2   Leiden University Medical Center, Internal Medicine, Leiden
,
M Nijhoff
2   Leiden University Medical Center, Internal Medicine, Leiden
,
O Korsgren
3   Uppsala University, Department of Immunology, Genetics and Pathology, Uppsala
,
O Eriksson
4   Uppsala University, Department of Medicinal Chemistry, Uppsala
,
M Brom
1   Radboudumc, Radiology and Nuclear Medicine, Nijmegen
,
M Gotthardt
1   Radboudumc, Radiology and Nuclear Medicine, Nijmegen
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2019 (online)

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Ziel/Aim:

Intrahepatic islet transplantation is performed in patients with complicated type 1 diabetes (T1D) and unstable glycemic control. This procedure improves glycemic control and quality of life, but graft function deteriorates over time due to various factors. A clinical tool to assess transplantation success and monitor islet survival and functionality would be of great value. We applied PET/CT imaging to study the presence of transplanted islets in T1D patients, using the beta-cell specific tracer Ga-68-exendin.

Methodik/Methods:

Dynamic Ga-68-exendin PET scans of 5 T1D patients with functional intrahepatic islet grafts and 3 control patients awaiting islet transplantation were acquired. The hepatic tracer uptake was measured by kinetic modeling using the Logan model. Islet function, expressed as c-peptide AUC within response to a mixed-meal tolerance test, was compared to the PET signal.

Ergebnisse/Results:

The control- and Tx-group did not differ in age (58.7 ± 5.5 vs. 54 ± 9.5 years, p = 0.57), BMI (24.5 ± 4.5 vs. 21.8 ± 1.4 kg/m2, p = 0.57) and HbA1c (62.3 ± 6.1 vs. 45.4 ± 12.8 mmol/mol, p = 0.14), though AUC for c-peptide (22.6 vs. 151.8 nmol.min/L, p < 0.05)) differed significantly. The amount of transplanted islet equivalents in the Tx-group was 9.6*105 ± 3.5*105. The distribution volume (Vt) of the PET tracer was significantly higher in the Tx-group, indicating an increased retention of Ga-68-exendin in the liver i.e. the presence of islets (0.53 ± 0.02 vs. 0.77 ± 0.06, p = 0.036). No significant correlation was found in the Tx-group between Vt and the number of islet equivalents, neither between Vt and C-peptide production.

Schlussfolgerungen/Conclusions:

Our preliminary data of this explorative study indicate that dynamic PET imaging using Ga-68-labeled exendin is a highly promising tool to monitor pancreatic islet grafts in T1D patients. Our interesting observation that there was no correlation between Vt and C-peptide production should be further studied using larger datasets.