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Exendin PET/CT for Imaging of Paragangliomas

Recruiting
Conditions
Paraganglioma
Interventions
Radiation: 68Ga-NODAGA-exendin-4 PET/CT
Registration Number
NCT05418907
Lead Sponsor
Radboud University Medical Center
Brief Summary

Functional imaging of paragangliomas (PGLs) is not unequivocal. Existing functional imaging modalities show good but variable results in PGLs, warranting the search for additional molecular imaging targets. Investigators aim to evaluate the glucagon-like peptide 1 receptor (GLP-1R) as a novel target for molecular imaging of PGLs. For this purpose investigators will use the tracer 68Ga-NODAGA-exendin 4 for positron emission tomography/computed tomography (PET/CT) imaging.

Detailed Description

Rationale:

Functional imaging of paragangliomas (PGLs) is not unequivocal. Existing functional imaging modalities show good but variable results in PGLs, warranting the search for additional molecular imaging targets. Investigators aim to evaluate the glucagon-like peptide 1 receptor (GLP-1R) as a novel target for molecular imaging of PGLs. For this purpose investigators will use the tracer 68Ga-NODAGA-exendin 4 for positron emission tomography/computed tomography (PET/CT) imaging.

Objective:

The primary objective is to examine the feasibility of 68Ga-exendin-4 PET/CT for localization and functional characterization of PGLs.

Study design:

In this prospective pilot imaging study 68Ga-exendin-4 PET/CT will be performed in 10 patients with confirmed PGL who have undergone CT, somatostatin receptor (SSTR) PET/CT and 18F-FDG PET/CT (as standard diagnostic procedures) and are scheduled for surgery. 100 ± 10 MBq 68Ga-NODAGA-exendin-4 will be administered to 10 patients in total. In the first 5 patients PET/CT imaging will be performed 1, 2 and 4 hours after injection to determine the optimal imaging timepoint for the remainder of the patients, which will be applied in the remaining patients.

The images will be reconstructed and evaluated by a nuclear medicine physician who is blinded to the results of the CT, SSTR PET/CT and 18F-FDG PET/CT to assess tumor detection. Additionally, quantitative analysis of 68Ga-exendin-4, SSTR PET and 18F-FDG PET/CT images will be performed. After the patients have undergone surgery, immunohistochemical analysis of surgical specimens will be performed to assess GLP-1R expression, which will be compared with in vivo tracer uptake.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
10
Inclusion Criteria
  • Proven sympathetic PGL with a single tumor detected using standard diagnostic imaging
  • No evidence of metastatic disease
  • CT, SSTR PET/CT and 18F-FDG PET/CT performed (golden standard diagnostic imaging)
  • Scheduled for surgery
  • Able to sign informed consent
Exclusion Criteria
  • Breast feeding
  • Pregnancy or the wish to become pregnant within 1 month
  • Calculated creatinine clearance below 40ml/min
  • Evidence of other malignancy than PGL in conventional imaging (suspicious liver, bone and lung lesions)
  • Age < 18 years
  • Not able to sign informed consent

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Patients with confirmed paraganglioma68Ga-NODAGA-exendin-4 PET/CT10 patients with confirmed PGL who have undergone CT, somatostatin receptor (SSTR) PET/CT and 18F-FDG PET/CT (as standard diagnostic procedures) and are scheduled for surgery.
Primary Outcome Measures
NameTimeMethod
detection rate of PGL's using 68Ga-exendin-4 PET/CT1 year

Detection based on visual inspection of PET/CT images

Secondary Outcome Measures
NameTimeMethod
optimal timepoint for imaging PGLs using 68Ga-exendin-4 PET/CTAfter inclusion of the first 5 patients (up to 6 months)

Trial Locations

Locations (1)

Radboud University Medical Center

🇳🇱

Nijmegen, Netherlands

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