Insulin Autoimmune Syndrome: Imaging Findings and Uptake Pattern With 68 Ga-Exendin-4 and 68 Ga-DOTATATE PET-CT.

Barapatre, Rucha; Verma, Priyanka; Lila, Anurag R; Basu, Sandip · Clin Nucl Med · 2026

case_report · Level V

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Abstract

A 62-year-old woman who experienced a seizure was found to be hypoglycemic. A prolonged fasting test revealed raised critical insulin and C-peptide levels. CECT of the abdomen demonstrated an isodense focus in the tail of the pancreas. On the suspicion of insulinoma, she was referred for a 68 Ga-Exendin-4 PET/CT study, which revealed diffuse tracer uptake in the entire pancreatic tissue. She also underwent a 68 Ga-DOTATATE PET/CT scan, which demonstrated physiological uptake in the pancreas. She later tested positive for anti-insulin antibodies. We herein report a positive Exendin-4 PET/CT study in a case of insulin autoimmune syndrome with its uptake pattern in this entity.

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