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Significance of Uptake in the Tail of the Pancreas in Patients Without Lesions

Delbeke, Dominique MD, PhD, FACNM*; Newman, Grace MD*; Deppen, Steve PhD†,‡,§; Shah, Chirayu MD†,∥; Ndolo, Josephine MD*; Shi, Chanjuan MD, PhD; Bailey, Christina E. MD#; Jessop, Aaron C. MD, MBA*; Sandler, Martin P. MD*

doi: 10.1097/RLU.0000000000002757
Original Articles

Purpose To measure the SUVs in the tail of the pancreas compared with normal liver parenchyma and somatostatin receptor–positive lesions.

Materials and Methods 68Ga-DOTATATE PET/low mAs CT of 35 patients were reviewed.

Results There was no significant difference (P = 0.59) between the SUVaverage of normal liver and the SUVpeak of normal tail. Five patients had uptake in the tail slightly above that of normal liver that were interpreted equivocally. In one of these patients with 68Ga-DOTATATE uptake in a peripancreatic lymph node, proven neuroendocrine tumor underwent a distal pancreatectomy and pathologic examination revealed islet cell hyperplasia.

Conclusions 68Ga-DOTATATE uptake in the tail of the pancreas above that of normal liver indicates a somatostatin receptor–avid lesion. Uptake in the tail of the pancreas equal to the liver can be normal. Patients with uptake equivalent to the liver should undergo further anatomical imaging before procedural intervention.

From the *Division of Nuclear Medicine, Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center

Veterans Affairs Hospital, Tennessee Valley Healthcare System

Department of Thoracic Surgery, Vanderbilt University Medical Center

§Vanderbilt-Ingram Cancer Center

Department of Radiology

Department of Pathology, Microbiology, and Immunology

#Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN.

Received for publication March 5, 2019; revision accepted July 1, 2019.

Conflicts of interest and sources of funding: none declared.

Correspondence to: Dominique Delbeke, MD, PhD, FACNM, Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, 1121, 21st Ave South CCC-1121 MCN, Nashville, TN 37232-2675. E-mail:

Online date: September 13, 2019

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