Longitudinal Assessment of 11C-5-Hydroxytryptophan Uptake in Pancreas After Debut of Type 1 Diabetes

The longitudinal alterations of the pancreatic beta-cell and islet mass in the progression of type 1 diabetes (T1D) are still poorly understood. The objective of this study was to repeatedly assess the endocrine volume and the morphology of the pancreas for up to 24 months after T1D diagnosis (n = 16), by C-11-5-hydroxytryptophan (C-11-5-HTP) positron emission tomography (PET) and MRI. Study participants were examined four times by PET/MRI: at recruitment and then after 6, 12, and 24 months. Clinical examinations and assessment of beta-cell function by a mixed-meal tolerance test and fasting blood samples were performed in connection with the imaging examination. Pancreas volume has a tendency to decrease from 50.2 +/- 10.3 mL at T1D debut to 42.2 +/- 14.6 mL after 24 months (P < 0.098). Pancreas uptake of C-11-5-HTP (e.g., the volume of the endocrine pancreas) did not decrease from T1D diagnosis (0.23 +/- 0.10 % of injected dose) to 24-month follow-up, 0.21 +/- 0.14% of injected dose, and exhibited low interindividual changes. Pancreas perfusion was unchanged from diagnosis to 24-month follow-up. The pancreas uptake of C-11-5-HTP correlated with the long-term metabolic control as estimated by HbA(1c) (P < 0.05). Our findings argue against a major destruction of beta-cell or islet mass in the 2-year period after diagnosis of T1D.

Automated summary

This study repeatedly assessed the endocrine volume and morphology of the pancreas in T1D patients using C-11-5-hydroxytryptophan PET and MRI for up to 24 months after diagnosis. The results showed a tendency of decreased pancreas volume but stable endocrine volume, which correlated with long-term metabolic control.