The pitfalls of 68Ga-DOTATATE Imaging. A case report
|Journal||Volume 86 - 2023|
|Issue||Fasc.1 - Case reports|
|Author(s)||V.A. D’Cruz 1, S. Libbrecht 2, A. Hoorens 2, K. De Man 3, G.H. van Ramshorst 4, K.P. Geboes 1|
VIEW FREE PDF
(1) Department of Gastroenterology, University Hospital Ghent, C. Heymanslaan 10, 9000 Gent, Belgium
(2) Department of Pathology, Ghent University Hospital, C. Heymanslaan 10, 9000 Gent, Belgium
(3) Department of Medical Imaging, Nuclear Medicine, University Hospital Ghent, C. Heymanslaan 10, 9000 Gent, Belgium
(4) Department of Gastrointestinal Surgery, Ghent University Hospital, C. Heymanslaan 10, 9000 Gent, Belgium
Neuroendocrine tumors (NETs) are a heterogeneous group of tumors exhibiting diverse clinical and biological characteristics. Despite the diverse nature of these neoplasms, they share common molecular targets which can be used with the help of nuclear medicine techniques for both imaging and therapy. 68Ga-DOTATATE was approved as a PET tracer by the FDA in June 2016 and allows whole-body imaging of cell surface expression of somatostatin receptors (SSTRs). Since then it has become a functional imaging technique that is a mainstay in the initial diagnostic work-up and staging of NETs. This imaging technique, however, has demonstrated pitfalls which need to be considered. Physiological uptake of 68Ga- DOTATATE occurs in a variety of tissues including the spleen, adrenal glands, kidneys, pituitary glands, liver, salivary glands and thyroid gland. SSTRs are also expressed on leucocytes and macrophages, resulting in inflammatory processes sometimes being misidentified with this imaging technique. We present a case with a radiological image that could be suggestive for a primary neuroendocrine tumor with desmoplastic reaction. 68Ga-DOTATATE showed no remarkable uptake in the central mass, but only faint uptake in the surrounding desmoplastic reaction. The final diagnosis on histological examination, was an inflammatory reaction surrounding biliary pigment.
|The authors declare that they have no conflict of interest.|
© Acta Gastro-Enterologica Belgica.