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Gallium-68-DOTA-exendin-4 is a **GLP-1 receptor targeted radiopharmaceutical PET imaging agent** composed of the peptide exendin-4 conjugated through an aminohexanoic acid linker to the DOTA chelator and labeled with gallium-68. It is used diagnostically rather than therapeutically, primarily for **PET/CT localization of insulinoma and other pancreatic islet cell tumors** in patients with endogenous hyperinsulinemic hypoglycemia, where GLP-1 receptor expression is typically high. The tracer functions by binding the glucagon-like peptide 1 receptor on tumor cells, enabling highly sensitive nuclear imaging; in practice it is commonly prepared locally in academic or hospital radiopharmacies rather than marketed as a widely commercial branded product by a single pharmaceutical sponsor.
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