Gallium-DOTATATE PET/CT

Neuroendocrine tumors (NETs) constitute a heterogeneous group of neoplasms, arising from endocrine cells within glands (adrenal medulla, pituitary, parathyroid) or from endocrine islets in the thyroid, pancreas, respiratory and gastrointestinal tracts.

• Most common tumors are:
  • Gastrointestinal NETs as carcinoids and gastrinoma
  • Pancreatic NETs as insulinoma, glucagonoma, VIPoma, and gastrinoma
  • Bronchopulmonary carcinoids
  • Sympatho-adrenal system tumors as pheochromocytoma, paraganglioma, neuroblastoma and ganglioneuroma
  • Medullary thyroid carcinoma
• Other non-NETs showing overexpression of somatostatin receptors as meningiomas, medulloblastomas, pituitary tumors, supratentorial primitive neuroectodermal tumors, and hemangioblastomas.

• Primary staging of a known neuroendocrine tumor before surgical and/or therapeutic planning.
• Localization of the primary tumor in case of metastatic neuroendocrine deposits.
• Determine somatostatin receptor (SST) status as patients with SST receptor-positive tumors are more likely to respond to Octreotide or radionuclide therapy with ¹⁷⁷Lutetium.
• Detection of NETs in patients with multiple endocrine neoplasia (MEN) of various types.
• Following up of known NETs patients to assess response to therapy.
• Used in brain tumors that show overexpression of somatostatin receptors, especially in post-operative assessment.

Case Ex.1

• ⁶⁸Ga-DOTATATE PET/CT detecting pancreatic neuroendocrine tumor less than 10mm in size.
• الفحص قادر علي اكتشاف اورام البرنكياس الصغيرة بدقة عالية التي يصعب اكتشافها بالفحوص الاخري.

Case Ex.2

• Ga-DOTATATE-PET/CT can detect and localize very small primary small bowel neuroendocrine tumors.
• يتميز الفحص باكتشاف اورام الامعاء الدقيقة بدقة عالية حتي وان كانت صغيرة جدا في الحجم.

Case Ex.3

• ⁶⁸Ga-DOTATATE showed a primary NET located in the duodenum as well as metastatic liver lesions. Both the primary tumor and liver metastases revealed only mild FDG uptake.
• اظهر الفحص ورم في الاثني عشر و ثانويات في الكبد لم تكن ظاهرة بوضوح في المسح الذري العادي.

Case Ex.4

• ⁶⁸Ga-DOTATATE-PET/CT shows highly avid bronchial carcinoid tumor, which only showed very low uptake in the FDG PET/CT scan.
• اظهر الفحص ورم في الرئة لم يكن ظاهر بوضوح في المسح الذري العادي.

Case Ex.5 (Non- NET)

Postoperative assessment in meningioma

• Ga-DOTATATE PET/CT shows increased uptake in the left frontal region denoting meningioma recurrence (C) which was confirmed at surgery. CT brain and FDG-PET/CT showed inconclusive results (A, B)

• اكتشاف ارتداد ورم بالمخ بعد ازالته جراحيا لم يكن ظاهرا في الاشعة المقطعية او المسح الذري العادي.