E2766. Gallium-68 DOTATATE PET/CT Evaluation of Pancreatic Neuroendocrine Tumor: Spectrum of Case-Based Multimodality Pictorial Review
Authors
Pokhraj Suthar;
Rush University Medical Center
Sumeet Virmani;
Rush University Medical Center
Background
Gallium-68 DOTATATE PET-CT is now considered the gold standard for imaging neuroendocrine tumors (NETs). Recent availability of this positron-emitting radio-labeled somatostatin analogue has a huge impact in the diagnosis, staging, and surveillance of patients with pancreatic NETs.
Educational Goals / Teaching Points
The purpose of this case-based pictorial exhibit is to highlight imaging spectrum of various findings including normal physiological distribution/variation, benign, incidental and pathologic abnormalities, multimodality comparison and its superiority over conventional CT/MR and octreotide imaging when available, and gallium-68 DOTATATE PET-CT impact over patient management in gastro-entero-pancreatic neuroendocrine tumor.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We present a case-based pictorial review highlighting the spectrum of 30 cases of pancreatic NETs and few false positives, such as intrapancreatic splenule and large uncinate process. This exhibit also highlights Gallium-68 DOTATATE PET-CT including localization of NETs, initial staging, selection of patients for PRRT (Lu-177), monitoring of NETs, evaluation of patients with biochemical evidence and symptoms of a NET without evidence on conventional imaging, restaging with clinical and laboratory progression without progression on conventional imaging, and correlation of Gallium-68 DOTATATE PET-CT with MRI/CT.
Conclusion
Gallium-68 DOTATATE PET-CT is the new gold standard for staging G1/ G2 well-differentiated pancreatic NETs and has a huge impact on patients management. The presented PET-CT pictorial review with multimodality correlation raises awareness and strengthens the judgment of the reading physician for pancreatic NETs.
