Gastric Carcinoid Tumor Ga-68 Dotatate PET-CT

                           (Prepared by Dr Isabel Berrocal)

            Female 54 year-old. Presented with upper gastrointestinal bleeding. A: Endoscopy showed an antral uplifted tumor with marked superficial vascularization in the posterior wall of gastric body (right, yellow arrows). B:  68Ga-Dotatate PET  and CT fusion images, coronal slice. Note rounded area in the stomach in the subcardial region, with maximun SUV = 7.3 (yellow arrow). C: The biopsy concluded gastric carcinoid. Chromogranin Immunohistochemical: gastric mucosa proliferation with neuroendocrine hyperplasia, adenomatoid hyperplasia and neuroendocrine neoplasia.

            Neuroendocrine tumors (NET) are a heterogeneous and rare group of neoplasms that originate from the neural crest. They have the  ability to overexpress somatostatin (SST) receptors. The main primary sites are the gastrointestinal tract and the lung. Other locations, such as the head and neck region or the prostate  can be affected. Gallium 68 radiolabeled with SST analogs PET shows high efficacy for detection. Whole-body imaging offers higher resolution and improved pharmacokinetics, with higher sensitivity for detection of SST receptor-expressing tumors. Gallium-68 PET has clinical impact and best results when it is used in combination PET - CT. It also indicates receptor expression for targeted radiopeptide therapy.

References:

1 Gabriel Michael et al. 68Ga-DOTA-Tyr3-Octreotide PET in Neuroendocrine Tumors: Comparison with Somatostatin Receptor Scintigraphy and CT. J Nucl Med 2007; 48:508–51.

2 Khan M.U. , Khan S. , et al. Clinical indications for Gallium-68 positron emission tomography imaging. European Journal of Surgical Oncology. Volume 35, Issue 6, June 2009, pp: 561-567.
 

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