1型糖尿病の“見える”膵臓評価を可能に―新規PET検査による膵β細胞量評価―

2026-03-13 京都大学

概念図作成：榊健太郎（京都大学）、一部素材は生成AI(ChatGPT-5.2)を用いて作成。

＜関連情報＞

• https://www.kyoto-u.ac.jp/ja/research-news/2026-03-13-1
• https://www.kyoto-u.ac.jp/sites/default/files/2026-03/web_2603_Sakaki-36d759d3e839760e9d8453333630c166.pdf
• https://diabetesjournals.org/diabetes/article/doi/10.2337/db25-1127/164564/Quantitative-Cell-Mass-Imaging-Redefines-Disease

定量的β細胞質量イメージングが1型糖尿病の病期分類と血糖コントロールを再定義 Quantitative β-Cell Mass Imaging Redefines Disease Staging and Glycemic Control in Type 1 Diabetes

Kentaro Sakaki;Takaaki Murakami;Hayao Yoshida;Daisuke Otani;Kanae Kawai Miyake;Yoichi Shimizu;Hiroyuki Fujimoto;Daisuke Yabe;Yuji Nakamoto;Nobuya Inagaki
Diabetes  Published:March 12 2026
DOI:https://doi.org/10.2337/db25-1127

Noninvasive measurement of pancreatic β-cell mass remains an important unmet need in type 1 diabetes because conventional surrogate markers, such as C-peptide, often lack sensitivity in advanced disease. This study evaluated the glucagon-like peptide 1 receptor–targeted positron emission tomography tracer, ¹⁸F-labeled exendin-4–based probe conjugated with polyethylene glycol, [¹⁸F]FB(ePEG12)12-exendin-4 (¹⁸F-exendin-4), to determine its ability to visualize pancreatic β-cell mass. Positron emission tomography/computed tomography performed at 60 and 120 min after tracer injection in individuals with type 1 diabetes was compared with data from healthy control participants. No serious adverse events occurred. Pancreatic uptake was consistently lower in individuals with type 1 diabetes and showed clear separation between individuals with insulin-dependent diabetes and healthy control participants at 120 min. Pancreatic uptake at 120 min correlated with fasting C-peptide index and inversely with hemoglobin A_1c and daily insulin dose per body weight. These findings support [¹⁸F]FB(ePEG12)12-exendin-4 positron emission tomography/computed tomography as a noninvasive approach for assessing β-cell mass and disease status.

Article Highlights

• We undertook this study to address the persistent need for noninvasive assessment of β-cell mass in type 1 diabetes.
• We aimed to determine whether ¹⁸F-exendin positron emission tomography/computed tomography can reliably visualize residual β-cell mass and distinguish stages of disease.
• We found that pancreatic tracer uptake was consistently reduced in type 1 diabetes, differentiated insulin-dependent patients from control participants, and aligned with markers of β-cell function and glycemic status.
• Our findings suggest that ¹⁸F-exendin imaging may offer fundamental platform for disease staging, therapeutic monitoring, and individualized care