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Spectrum of 68Ga-DOTA TATE Uptake in Patients With Neuroendocrine Tumors

Moradi, Farshad MD, PhD; Jamali, Mehran MD; Barkhodari, Amir MD; Schneider, Bernadette BA; Chin, Frederick PhD; Quon, Andrew MD; Mittra, Erik S. MD, PhD; Iagaru, Andrei MD

doi: 10.1097/RLU.0000000000001100
Original Articles
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Purpose To analyze the biodistribution of 68Ga-DOTA-TATE in the normal tissues and uptake in benign, indeterminate, and malignant lesions in a population of patients with known neuroendocrine tumors (NET) using semiquantitative standardized uptake values (SUV) measurements.

Methods One hundred four consecutively scanned patients (51 men and 53 women; mean age, 56.4 years) with confirmed diagnosis of NET underwent PET/CT 1 hour after administration of 68Ga-DOTA-TATE. SUVmean, and SUVmax were measured in 37 normal anatomical structures for each patient. Abnormal uptake was divided into benign, indeterminate, and malignant categories based on imaging characteristic, clinical follow-up, and pathology.

Results High physiologic uptake (SUVmax > 7) was observed in spleen, renal parenchyma, adrenal glands, pituitary gland, stomach, and liver (in decreasing order). Moderate uptake (3.5–7) was present in the prostate, jejunum, pancreas, ileum, and salivary glands. Mild uptake (2–3.5) was present in the uterus, colon, thyroid, rectum, and skeleton. A total of 678 lesions (limited to 5 lesions with highest uptake per organ) were included in the analysis, including 127 benign and 54 indeterminate lesions. Uptake was significantly higher in malignant lesions than in benign lesions, but an overlap was noted between the groups.

Conclusions 68Ga-DOTA TATE uptake in normal and abnormal structures is highly variable in patients with NET. SUV is a useful measure for characterizing benign versus malignant lesions. Anatomical and clinical correlation may be necessary to characterize foci of intermediate uptake.

From the *Division of Nuclear Medicine and Molecular Imaging, Stanford University, Stanford, CA; and †Molecular Imaging Program at Stanford, Stanford University, Stanford, CA.

Received for publication October 26, 2015; revision accepted October 29, 2015.

Conflicts of interest and sources of funding: none declared.

Correspondence to: Andrei Iagaru, MD, Division of Nuclear Medicine and Molecular Imaging, Stanford University, 300 Pasteur Dr, Room H-2200, Stanford, CA 94305. E-mail: aiagaru@stanford.edu.

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