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68Ga-NODAGA-Exendin-4 is a diagnostic radiopharmaceutical composed of the peptide exendin-4, a potent glucagon-like peptide 1 receptor (GLP-1R) agonist, conjugated to the chelator NODAGA and labeled with the positron-emitting radionuclide gallium-68. Exendin-4 specifically binds to GLP-1 receptors, which are highly expressed on pancreatic β-cells and certain neuroendocrine tumors such as insulinomas. The drug is used in PET/CT imaging for non-invasive localization of insulinomas and focal lesions in congenital hyperinsulinism (CHI), offering high sensitivity and superior image quality compared to other tracers like 18F-DOPA. Its mechanism involves targeting GLP-1R for visualization rather than therapeutic modulation[1][3][4][10]. Developed primarily by Radboud University Nijmegen, it remains investigational with its highest development phase being preclinical or early clinical studies[2].
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