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The relationship between cholecystokinin secretion and pancreatic [11C]methionine uptake in patients after partial pancreaticoduodenectomy

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  • Emanuel Steiner
  • Lukas Kazianka
  • Robert Breuer
  • Marcus Hacker
  • Wolfgang Wadsak
  • Markus Mitterhauser
  • Jens F Rehfeld
  • Georgios Karanikas
  • Johannes Miholic
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OBJECTIVE: The pancreatic uptake of [11C]methionine ([11C]MET) is associated with beta-cell function and insulin secretion, but [11C]MET uptake and its relationship with exocrine pancreatic performance are less well studied. The postprandial release of cholecystokinin (CCK) depends on gastric emptying velocity and triggers exocrine pancreas secretion. Therefore, we assumed that high postprandial CCK concentrations stimulate the uptake of [11C]MET in the residual pancreas following pancreaticoduodenectomy.

METHODS: Nineteen tumor-free patients after pancreaticoduodenectomy (median age: 64; 25/75 quantile: 56-67 years); ten males, nine females and ten healthy controls (median age: 24; 25/75 quantile: 23.8-26 years) were given a mixed meal. Plasma CCK, insulin and glucose concentrations were measured before and at 10, 20, 30, 60, 90, 150 and 180 min after ingestion. Simultaneously, 800 MBq of [11C]MET were administered and the activity [maximum tissue standardized uptake values (SUVmax)] over the pancreas was measured using PET-CT at 15, 30 and 60 min after injection.

RESULTS: Integrated CCK (AUC30) correlated with SUVmax (AUC60, R2 = 0.45, p value = 0.0013). Multivariate analysis revealed postprandial insulin (AUC60) and CCK concentrations and young age as significant independent predictors of [11C] methionine uptake.

CONCLUSION: The association between CCK concentrations and pancreatic [11C]MET uptake might indicate a causal relationship. Further research should assess whether [11C]MET uptake could serve as a less invasive tool to assess exocrine pancreas activity.

Original languageEnglish
JournalAnnals of Nuclear Medicine
Volume34
Issue number9
Pages (from-to)691-695
Number of pages5
ISSN0914-7187
DOIs
Publication statusPublished - Sep 2020

    Research areas

  • Cholecystokinin, Exocrine pancreas, Methionine, Pancreaticoduodenectomy, Positron emission tomography

ID: 60898706