Ga-68 DOTATOC* PET•CT Study in a Patient with Pancreatic Neuroendocrine Tumor with Liver Metastases

 

Prof. Dr. A. Bockisch, MD and Dr. J. Nagarajah, MD, Dept of Nuclear Medicine, University Hospital of Essen, Essen, Germany |  Dec 01, 2013

History

A 71-year-old female patient (43 kg/94.7 lbs) presented with multiple space-occupying lesions in the liver, which were histopathologically confirmed to be metastatic neuroendocrine tumors. The patient was referred for a Ga-68-DOTATOC-PET•CT study for initial staging to evaluate the extent of metastases and detect the primary tumor site. The study was performed on a Biograph™ mCT, 30 min following an IV injection of 70 MBq of Ga-68 DOTATOC.

Diagnosis

The lesion in the head of the pancreas appears to be the site of the primary tumor with multiple liver metastases. Clinical evaluation of the the Ga-68-DOTATOC-PET•CT study defined the primary pancreatic neuroendocrine tumor and the extent of liver metastases, as well as the absence of well-defined metastatic lesions in the rest of the body. Based on the findings of high levels of Ga-68 DOTATOC uptake in the primary and metastatic lesions, Y-90-DOTATOC therapy was recommended to the patient.

Comments

 Although the primary pancreatic lesion in this clinical example was large enough to be visible on contrast CT, small and early lesions often require a combination of morphological and functional imaging for proper detection. Biograph mCT with the industry’s highest volumetric resolution** along with point spread function (PSF) reconstruction (HD•PET) delivers uniform resolution throughout the field of view.

Examination Protocol

Scanner:        Biograph mCT

Scan dose:    70 MBq (1.6 MBq/kg) Ga-68 DOTATOC

Scan delay:   30 minutes post injection

Acquisition    2 min/bed, TrueV, HD•PET
Parameters:   reconstruction

CT:                120 kV, 210 ref mAs
                      3mm slice thickness

1 Ga-68 DOTATOC referenced herein is not currently recognized by the US FDA as being safe and effective, and Siemens does not make any claims regarding its use.

2510(k) pending.