Noninvasive Imaging of Islet Transplants with 111In-Exendin-3 SPECT/CT.

I. van der Kroon, K. Andralojc, S. Willekens, D. Bos, L. Joosten, O. Boerman, M. Brom and M. Gotthardt




Islet transplantation is a promising treatment for type 1 diabetic patients. However, there is acute as well as chronic loss of islets after transplantation. A noninvasive imaging method that could monitor islet mass might help to improve transplantation outcomes. In this study, islets were visualized after transplantation in a rat model with a dedicated small-animal SPECT scanner by targeting the glucagonlike peptide-1 receptor (GLP-1R), specifically expressed on ?-cells, with (111)In-labeled exendin-3. Targeting of (111)In-exendin-3 to GLP-1R was tested in vitro on isolated islets of WAG/Rij rats. For in vivo evaluation, 400 or 800 islets were transplanted into the calf muscle of WAG/Rij rats (6-8 wk old). Four weeks after transplantation, SPECT/CT images were acquired 1 h after injection of (111)In-labeled exendin-3. After SPECT acquisition, the muscles containing the transplant were analyzed immunohistochemically and autoradiographically. The binding assay, performed on isolated islets, showed a linear correlation between the number of islets and (111)In-exendin-3 accumulation (Pearson r = 0.98). In vivo, a 1.70 ± 0.44-fold difference in tracer uptake between 400 and 800 transplanted islets was observed. Ex vivo analysis of the islet transplant showed colocalization of tracer accumulation on autoradiography, with insulin-positive cells and GLP-1R expression on immunohistochemistry. (111)In-exendin-3 accumulates specifically in the ?-cells after islet transplantation and is a promising tracer for noninvasive monitoring of the islet mass.