Positron Emission Tomography

68Gallium-DOTATATE is a somatostatin analog PET/CT tracer that binds to the somatostatin receptors which are over expressed in neuroendocrine tumors.

This exam is recommended for neuroendocrine tumor imaging by:

The National Comprehensive Cancer Network (NCCN),The American Society of Clinical Oncology (ASCO)The Endocrine Society, Society of Nuclear Medicine and Molecular Imaging (SNMMI), The European Association of Nuclear Medicine (EANM), The American College of Radiology (ACR), The North American Neuroendocrine Tumor Society (NANETS).


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.


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