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Monitoring β-Cell Survival After Intrahepatic Islet Transplantation Using Dynamic Exendin PET Imaging: A
Theodorus J P Jansen1, Mijke Buitinga2,3, Marti Boss1
1Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands.
Diabetes
|April 17, 2023
Summary
Radiolabeled exendin PET/CT imaging successfully monitors transplanted islet cell mass in type 1 diabetes patients. This noninvasive technique helps assess graft viability after intrahepatic islet transplantation (ITx).
Area of Science:
- Nuclear Medicine
- Endocrinology
- Transplantation Immunology
Background:
- Intrahepatic islet transplantation (ITx) is a viable treatment for type 1 diabetes but graft function declines over time.
- Noninvasive monitoring technologies are crucial for assessing transplanted islet survival and function.
- Current methods lack the precision to quantify beta-cell mass in situ after ITx.
Purpose of the Study:
- To evaluate the feasibility of using [68Ga]Ga-NODAGA-exendin-4 (68Ga-exendin) PET/CT imaging for quantifying beta-cell mass in intrahepatic islet grafts.
- To demonstrate the potential of 68Ga-exendin PET/CT as a noninvasive tool for monitoring ITx outcomes.
Main Methods:
- A clinical study involving 13 individuals with type 1 diabetes (9 ITx recipients, 4 controls).
- Dynamic 68Ga-exendin PET/CT imaging to quantify tracer accumulation in hepatic hotspots.
- Assessment of beta-cell function via mixed-meal tolerance tests and intrahepatic fat using MRI/spectroscopy.
Main Results:
- Significantly higher 68Ga-exendin uptake was observed in the hepatic hotspots of the ITx group compared to controls.
- Immunohistochemistry confirmed GLP-1 receptor expression in transplanted islets, validating the tracer's target.
- Intrahepatic fat was not a confounding factor in the majority of participants.
Conclusions:
- This study provides the first clinical evidence supporting the use of radiolabeled exendin imaging for monitoring viable transplanted islets after intraportal ITx.
- 68Ga-exendin PET/CT imaging can quantitatively assess beta-cell mass, aiding in the evaluation of strategies to improve islet engraftment, survival, and function.
