{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T04:40:27Z","timestamp":1764304827262,"version":"3.41.2"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Horm Metab Res"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The data on the use of 68Ga-NODAGA-exendin-4 PET\/CT in localizing multiple\n                    endocrine neoplasia type 1 (MEN1)-related insulinomas is evolving; however,\n                    surgical outcomes data are not available. We describe our cohort of patients\n                    with MEN1-related endogenous hyperinsulinemic hypoglycemia (EHH), where\n                    68Ga-NODAGA-exendin-4 PET\/CT was used to guide conservative surgery. A\n                    retrospective record review of MEN1-related EHH cases managed between 2000 and\n                    2024 was performed for clinical features, imaging, and management. Outcomes were\n                    assessed for patients whose surgical extent was determined by\n                    68Ga-NODAGA-exendin-4 PET\/CT versus conventional imaging (CECT and 68Ga-DOTATATE\n                    PET\/CT). Five patients with a median age of 17 (15.5\u201318.5 years) with EHH\n                    underwent laparoscopic, single lesion enucleation based on 68Ga-NODAGA-exendin-4\n                    PET\/CT. On preoperative imaging, CT identified culprit lesion in four, while\n                    68Ga-DOTATATE PET\/CT localized in one, and had one false positive uptake in\n                    non-functioning NET. The median duration of hospital stay was 6 (5.5\u20139) days.\n                    Over a median follow-up of 48 (3.5\u201384.5) months, none had EHH recurrence or\n                    exocrine\/endocrine pancreatic insufficiency. On follow-up, one patient had an\n                    uneventful pregnancy and delivery. In the remaining 15, who underwent surgery\n                    based on conventional imaging, 12 (80%) required extensive surgery beyond\n                    enucleation, of which two needed intraoperative ultrasound localization. This\n                    group had a postoperative hospital stay of 11 (8\u201323) days, one recurrence after\n                    84 months, and pancreatic insufficiency in 5 (33%). Our center observation\n                    suggests that GLP1R-based PET\/CT-guided conservative insulinoma surgery in MEN1\n                    patients is effective and safe and needs further validation.<\/jats:p>","DOI":"10.1055\/a-2620-2931","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T22:46:36Z","timestamp":1748040396000},"page":"366-372","source":"Crossref","is-referenced-by-count":1,"title":["Outcomes of 68Ga-NODAGA-Exendin-4 PET\/CT Guided Surgical Management\n                    of Insulinomas in MEN1: A Preliminary Study"],"prefix":"10.1055","volume":"57","author":[{"given":"Ketki Sunil","family":"Ambulkar","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism, Seth GS\n                    Medical College and KEM Hospital, Mumbai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ravikumar","family":"Shah","sequence":"first","affiliation":[{"name":"Harikrushna Hormone Clinic, Anand, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anurag","family":"Lila","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Seth GS\n                    Medical College and KEM Hospital, Mumbai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anima","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Seth GS\n                    Medical College and KEM Hospital, Mumbai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohit","family":"Barnabas","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Seth GS\n                    Medical College and KEM Hospital, Mumbai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manjiri","family":"Karlekar","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Seth GS\n                    Medical College and KEM Hospital, Mumbai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saba Samad","family":"Memon","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Seth GS\n                    Medical College and KEM Hospital, Mumbai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vijaya","family":"Sarathi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Vydehi Institute of Medical\n                    Sciences and Research Centre, Bangalore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sameer","family":"Rege","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Seth GS Medical College\n                    and KEM Hospital, Mumbai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priyanka","family":"Verma","sequence":"additional","affiliation":[{"name":"Radiation Medicine Centre, Bhabha Atomic Research\n                    Centre, Mumbai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaurav","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Radiation Medicine Centre, Bhabha Atomic Research\n                    Centre, Mumbai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikram","family":"Lele","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Jaslok Hospital &\n                    Research Center, Mumbai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6902-4639","authenticated-orcid":false,"given":"Tushar","family":"Bandgar","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Seth GS\n                    Medical College and KEM Hospital, Mumbai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,6,23]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1210\/clinem\/dgad641","article-title":"Approach to the patient: insulinoma","volume":"109","author":"J Hofland","year":"2024","journal-title":"J Clin Endocrinol Metab"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1111\/cen.14406","article-title":"Exendin-4-based imaging in insulinoma localization: systematic review and\n                    meta-analysis","volume":"95","author":"R Shah","year":"2021","journal-title":"Clin Endocrinol (Oxf)"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1210\/jc.2008-1986","article-title":"Localization of insulinomas to regions of the pancreas by intraarterial calcium\n                    stimulation: the NIH experience","volume":"94","author":"J-M Guettier","year":"2009","journal-title":"J 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68Ga-NOTA-exendin-4 for detecting\n                    localized insulinoma: a prospective cohort study","volume":"57","author":"Y Luo","year":"2016","journal-title":"J Nucl Med"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"5843","DOI":"10.1210\/jc.2018-02754","article-title":"68Ga-Exendin-4 PET\/CT detects insulinomas in patients with endogenous\n                    hyperinsulinemic hypoglycemia in MEN-1","volume":"104","author":"K Antwi","year":"2019","journal-title":"J Clin Endocrinol Metab"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1507\/endocrj.EJ12-0173","article-title":"Clinical features of insulinoma in patients with multiple endocrine neoplasia\n                    type 1: analysis of the database of the MEN consortium of Japan","volume":"59","author":"A Sakurai","year":"2012","journal-title":"Endocr J"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1530\/EJE-14-0878","article-title":"Long-term results of the surgical management of insulinoma patients with MEN1: a\n                    Groupe d\u2019\u00e9tude des Tumeurs Endocrines (GTE) retrospective study","volume":"172","author":"D Vezzosi","year":"2015","journal-title":"Eur J Endocrinol"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1186\/s13023-022-02370-1","article-title":"Analysis of 55 patients with multiple endocrine neoplasia type 1-associated\n                    insulinoma from a single center in China","volume":"17","author":"Y Zhao","year":"2022","journal-title":"Orphanet J Rare Dis"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"15164","DOI":"10.3390\/ijms242015164","article-title":"Immunohistochemical glucagon-like peptide-1 receptor expression in human\n                    insulinomas","volume":"24","author":"T Vesterinen","year":"2023","journal-title":"Int J Mol Sci"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.pan.2019.12.017","article-title":"Occult insulinoma, glucagonoma and pancreatic endocrine pseudotumour in a\n                    patient with multiple endocrine neoplasia type 1","volume":"20","author":"T D Erichsen","year":"2020","journal-title":"Pancreatology"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s12893-018-0376-5","article-title":"Robotic enucleation for pediatric insulinoma with MEN1 syndrome: a case report\n                    and literature review","volume":"18","author":"M Liang","year":"2018","journal-title":"BMC Surg"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1007\/s00259-012-2299-1","article-title":"Glucagon-like peptide-1 receptor imaging with\n                    [Lys40(Ahx-HYNIC-99mTc\/EDDA)NH2]-exendin-4 for the detection of insulinoma","volume":"40","author":"A Sowa-Staszczak","year":"2013","journal-title":"Eur J 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