Evaluation of Metastatic Insulinoma With Severe Hypoglycemia Using 68 Ga-Exendin-4 PET/CT.

Gao, Jing; Xu, Junyan; Liang, Yun; Chen, Jie; Song, Shaoli · Clin Nucl Med · 2025

case_report · Level V

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Abstract

A 52-year-old man was pathologically diagnosed with a pancreatic neuroendocrine tumor (pNET) and synchronous liver metastasis through debulking surgery 2 years ago. Recently, the patient showed recurrent severe hypoglycemia after receiving multiple treatments. 68 Ga-Exendin-4 PET/CT imaging revealed diffuse uptake in the skeleton and other metastatic sites, which 68 Ga-DOTANOC PET/CT grossly underestimated. This case highlights the crucial role of 68 Ga-Exendin-4 in the comprehensive and accurate evaluation of metastatic insulinomas.

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