{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:53:36Z","timestamp":1753890816683,"version":"3.41.2"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Positron-emission-tomography-(PET)\/computed-tomography-(CT) using somatostatin-receptor-(SSTR)-binding radioligands is well established in the imaging of neuroendocrine tumors (NETs). SSTRs are expressed in NETs and endocrine and exocrine tissues, e.g. pancreas, where somatostatin binding to SST2 and SST5 inhibits glucagon and insulin secretion. Pancreatic background activity on SSTR-PET varies widely and is increased in up to 45% of cases. High uptake in the <jats:italic>processus uncinatus<\/jats:italic> can obscure NETs or cause false positives. The determinants of elevated pancreatic activity on SSTR-PET remain unclear, prompting investigation into the association between pancreatic radioligand uptake and diabetic status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients with non-pancreatic NETs undergoing [68Ga]Ga-DOTATOC-PET\/CT at LMU clinic with available HbA1c were included. Patients were grouped: without glucose metabolism disorder (HbA1c 4.0-5.6%), prediabetes (HbA1c 5.7-6.4%), type 2 diabetes mellitus. Pancreatic volume and tracer uptake were assessed, with correlation and regression analyses between SSTR expression and HbA1c.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 40 patients (54 scans; n=22: normal glucose metabolism, n=20: prediabetes, n=12: diabetes; n=11: antidiabetic medication (AM)). Patients with normal glucose homeostasis showed increased tracer-uptake than those with impaired glucose metabolism (p=0.033; p=0.009). Correlation analysis revealed a significant negative correlation of HbA1c and SUVmax in patients without AM (r2 = 0.267; p&amp;lt;0.001). Multiple linear regression analysis with AM as a covariate revealed a significant association between HbA1c and SUVmax (r2 = 0.667; CI -0.371 to -0.135; p&amp;lt;0.001), AM was a significant covariate (CI 1.393 to 2.120; p&amp;lt;0.001). The association between HbA1c and SUVmean showed a trend (p=0.061) but no statistical significance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings indicate a significant association between pancreatic [68Ga]Ga-DOTATOC-uptake and glucose metabolism, suggesting that [68Ga]Ga-DOTATOC-PET\/CT sensitivity for detecting pancreatic NETs may be affected by individual glucose homeostasis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1536301","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T04:10:37Z","timestamp":1747368637000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of hyperglycemia and antidiabetic medication on pancreatic uptake on [68Ga]Ga-DOTATOC PET\/CT"],"prefix":"10.3389","volume":"16","author":[{"given":"Sophie Carina","family":"Kunte","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thorsten","family":"Siegmund","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximilian","family":"Tiling","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lukas","family":"Ostermair","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lena Maria","family":"Unterrainer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marily","family":"Theodoropoulou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Reincke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Friederike","family":"V\u00f6lter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-023-09518-y","article-title":"Validation of the SSTR-RADS 1.0 for the structured interpretation of SSTR-PET\/CT and treatment planning in neuroendocrine tumor (NET) patients","volume":"33","author":"Grawe","year":"2023","journal-title":"Eur Radiol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-017-3728-y","article-title":"Guideline for PET\/CT imaging of neuroendocrine neoplasms with (68)Ga-DOTA-conjugated somatostatin receptor targeting peptides and (18)F-DOPA","volume":"44","author":"Bozkurt","year":"2017","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.111.091165","article-title":"68Ga-DOTATOC versus 68Ga-DOTATATE PET\/CT in functional imaging of neuroendocrine tumors","volume":"52","author":"Poeppel","year":"2011","journal-title":"J Nucl Med"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-021-05351-x","article-title":"Dosimetry and optimal scan time of [(18)F]SiTATE-PET\/CT in patients with neuroendocrine tumours","volume":"48","author":"Beyer","year":"2021","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s002590050034","article-title":"Affinity profiles for human somatostatin receptor subtypes SST1-SST5 of somatostatin radiotracers selected for scintigraphic and radiotherapeutic use","volume":"27","author":"Reubi","year":"2000","journal-title":"Eur J Nucl Med"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1007\/s11154-018-9470-3","article-title":"Somatostatin receptor expression in non-classical locations - clinical relevance","volume":"19","author":"Bhanat","year":"2018","journal-title":"Rev Endocr Metab Disord"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.00207.2012","article-title":"SSTR2 is the functionally dominant somatostatin receptor in human pancreatic \u03b2- and \u03b1-cells","volume":"303","author":"Kailey","year":"2012","journal-title":"Am J Physiol Endocrinol Metab"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/S0303-7207(02)00131-4","article-title":"Expression of chromogranin A and somatostatin receptors in pancreatic AR42J cells","volume":"194","author":"Hofsli","year":"2002","journal-title":"Mol Cell Endocrinol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbadis.2017.11.002","article-title":"Characterization of somatostatin receptors and associated signaling pathways in pancreas of R6\/2 transgenic mice","volume":"1864","author":"Somvanshi","year":"2018","journal-title":"Biochim Biophys Acta (BBA) - Mol Basis Dis"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9258(19)57455-5","article-title":"Somatostatin receptors on rat pancreatic acinar cells. 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