Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Case betacure

220 views

Published on

BetaCure: Personalized diagnosis and treatment of
hyperinsulinemic hypoglycaemia caused by beta-cell
pathology

Published in: Health & Medicine
  • Be the first to comment

  • Be the first to like this

Case betacure

  1. 1. The research leading to these results has received funding from the European Community’s Seventh Framework Programme (FP7/2007– 2013) under grant agreement n° 602812 BetaCure: Personalized diagnosis and treatment of hyperinsulinemic hypoglycaemia caused by beta-cell pathology www.betacure.eu Pirjo Nuutila Turun PET-keskus Turku yliopisto, Tyks Turku
  2. 2. EU FP7 HEALTH.2013.1.2-1: Development of imaging technologies for therapeutic interventions in rare diseases
  3. 3. 18F-DOPA PET as a Tool to Localize an Insulinoma or -Cell Hyperplasia in Adult Patients Insulinoma in adults: Insidence 1-4 /1 milj., diameter < 2 cm *** In 2001, a 34-year-old female patient with severe symptoms and focal ß-cell hyperplasia imaged with 18F-DOPA PET. Focus in the head of the pancreas. Operation -> focal hyperplasia -> cured The first aricle: 10 adult patients 8 insulinomas 2 hyperplasia) Kauhanen, Nuutila, JCEM 2007
  4. 4. * Conventional imaging CT, MRI: not informative • Functional tests invasive,not sensitive(Arterial Ca stimulation / venous sampling (ASVS), pancreatic venous sampling (PVS) through intrahepatic portal catheterization Congenital hyperinsulinism (CHI), 1/50 000 birth • All islets are affected •Conservative Treatment -> near- total pancreatectomy • Long-term outcome: High risk of diabetes Diffuse Focal •Focal adenomatous hyperplasia • Paternally inherited recessive mutations in SUR1, Kir6.2 • Treatment: Selective resection of the focal lesion* • Outcome: Cure
  5. 5. Pancreatic -cell mass/function FDOPA PET in 20 CHI patients at the Turku PET Centre since 2002 Focus Otonkoski, Nuutila et al, Diabetes, 2006 Pancreatic focal  cell hyperplasia in infants can be localized using 18F-DOPA in infants
  6. 6. Exendin SPECT/PET tracers • 111In-Exendin SPECT/CT scan of a patient with a history of 17 years of recurrent hypogly- caemias in whom no focus could be identified (18F-DOPA/ 111In-octreotide/MRI/endoscopic & intraoperative ultrasound). • Increased beta cell activity in the tip of the pancreatic tail and the pancreatic head (arrow) • Microautoradiography showing specific uptake in the beta-cells/islets ( rat pancreas dissected 1 h p.i. of 15 MBq [Lys40(111In-DTPA)]exendin-3)
  7. 7. AIMS • In Finland • Optimization and characterization of tracers (18F-Exendin, preclinical ) • Optimized pre-operative imaging will be performed using Ga-68- Exendin by PET for identification of foci and for determination of the beta cell mass • adult hyperinsulinemic hypoglycaemia (AHH) : ethical approval, Fimea in progress • Congenital hypoglymia in infancy (CHI) : pending
  8. 8. WP 5, Photodynamic Therapy UMCG, van Dam, Nature Med 2011
  9. 9. Turku PET Centre • Finnish national research institute started in 1974, status in 1995 • Owned by University of Turku (UTU), Åbo Akademi University, Turku University Hospital • Expertise in PET tracer development, preclinical and clinical PET research, diagnostic services, and contract research for the pharmaceutical industry. • More than 130 staff members and investigators 3 cyclotrons, 16 hot cells for GMP level PET tracer production • PETMRI, 2 PETCT, 2 PET, MRI, digital US, a small animal PET/CT • ~100 international publications annually
  10. 10. Betacure team in Turku P rof Pirjo Nuutila, PI • Prof Pirjo Nuutila, PI • Docent Marko Seppänen, MD: diagnostic services • Dr. Saila Kauhanen, MD, • Prof. Olof Solin, PhD, coordination of radiochemistry • Chen Yen-Bin, PhD:Peptide chemistry, labeling syntheses • Pauliina Lehtiniemi, MSc • Kirsi Mikkola, MSc; preclinical studies • . The research leading to these results has received funding from the European Community’s Seventh Framework Programme (FP7/2007– 2013) under grant agreement n° 602812

×