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ACR Practice Parameter for the Performance of Gallium-68 DOTATATE PET/CT for Neuroendocrine Tumors

Subramaniam, Rathan M., MD, PhD, MPH*; Bradshaw, Marques L., MD; Lewis, Kenneth, PhD; Pinho, Daniella, MD*; Shah, Chirayu, MD; Walker, Ronald C., MD, FACR

doi: 10.1097/RLU.0000000000002309
Original Articles

Radiopharmaceuticals targeting cell surface expression of somatostatin receptors (SSTRs) are particularly useful in the evaluation of neuroendocrine tumors. Gallium-68 DOTA-Tyr3-octreotatate (68Ga-DOTATATE) primarily binds to SSTR type 2 receptors. 68Ga DOTATATE PET/CT is proven to have high impact on the management of neuroendocrine patients compared to traditional anatomical imaging as well as provides additional information over that of conventional nuclear medicine studies (indium-III DTPA-octreotide). It can result in change in management of approximately 75% of patients with neuroendocrine tumors. 68Ga DOTATATE and 18F FDG PET/CT imaging are complementary, with the degree of uptake varying depending on the degree of differentiation of the tumor. Well-differentiated tumors maintain their SSTRs and are positive on 68Ga DOTATATE PET/CT scan, while dedifferentiated tumors are less likely to demonstrate uptake of 68Ga DOTATATE but will demonstrate uptake with 18F FDG PET/CT. In addition, 68Ga DOTATATE PET/CT identifies patients with SSTR expression in their tumors, who have progressed on somatostatin analog therapy, for treatment with 177Lu DOTATATE.

From the *Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX; and

Department of Radiology, Vanderbilt University Medical Center, Nashville, TN.

Received for publication July 12, 2018; revision accepted July 27, 2018.

Conflicts of interest and sources of funding: none declared.

Correspondence to: Rathan M Subramaniam, MD, PhD, MPH, Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, Tx 75390-8896. E-Mail:

Practice parameters and technical standards are published annually with an effective date of October 1 in the year in which amended, revised or approved by the ACR Council. For practice parameters and technical standards published before 1999, the effective date was January 1 following the year in which the practice parameter or technical standard was amended, revised, or approved by the ACR Council.

Development Chronology for This Practice Parameter: Adopted 2018 (Resolution 32).

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