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Gallium Ga-68 exendin (specifically gallium Ga-68 exendin-4) is a diagnostic radiopharmaceutical PET imaging tracer targeting the glucagon-like peptide-1 receptor (GLP-1R). It consists of the GLP-1R agonist exendin-4 (a 39-amino acid peptide analog of GLP-1) conjugated to a chelator (such as NODAGA, NOTA, DOTA, or DO3A) and radiolabeled with the positron-emitting isotope gallium-68 (Ga-68). GLP-1R is highly expressed on pancreatic beta cells and overexpressed in benign insulinomas. Gallium Ga-68 exendin PET/CT imaging is used for the preoperative localization of insulinomas, the detection of focal congenital hyperinsulinism (CHI), and the noninvasive monitoring of pancreatic islet grafts in patients with type 1 diabetes.
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