Exendin-4 Imaging for Pancreatic Tumours

​Insulinomas are rare, usually pancreatic tumours that overproduce insulin, leading to recurrent episodes of low blood sugar. They can be as small as a few millimetres and are often difficult to locate. Symptoms of low blood sugar may include tremors, confusion, fainting and seizures, which resolve when blood sugar levels return to normal. The condition occurs more frequently in females, typically between ages 40 and 60. 

Exendin-4 imaging is a specialised diagnostic scan offered at Singapore General Hospital (SGH) to detect insulinomas. It combines Positron Emission Tomography (PET) with Computed Tomography (CT) to create detailed images of the pancreas.  

During the scan: 

• A substance called exendin-4, tagged with a radioactive material, is administered 
• The tagged exendin-4 binds specifically to insulinomas 
• The tumours appear as distinct bright spots on the scan 
• This helps pinpoint their exact location within the body 
   

When Can Exendin-4 be Used?

This scan may be recommended when: 

• Standard imaging tests (CT or MRI) have not clearly shown the tumour 
• Traditional diagnostic methods have not provided conclusive results 
• More precise tumour location is needed for treatment planning 

Benefits 

• Helps detect very small tumours 
• Improves diagnostic accuracy 
• Aids in planning appropriate treatment 
• May help determine suitability for minimally invasive treatment options 

This scan requires a referral from your specialist doctor. Get in touch with the department of Nuclear Medicine and Molecular Imaging to find out more.