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Diagnostic Value of 68Ga-DOTATATE PET/CT in Liver Metastases of Neuroendocrine Tumours of Unknown Origin

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Abstract

Purpose

In neuroendocrine liver metastases of unknown primary, a multimodality approach is usually adopted and consists of transabdominal ultrasound, endoscopic ultrasound (EUS), computed tomography (CT), magnetic resonance imaging (MRI), nuclear medicine techniques, endoscopy and exploratory surgery. The purpose of the study is to evaluate the diagnostic value of 68Ga-DOTATATE positron emission tomography (PET)/CT as part of a multimodality approach in neuroendocrine liver metastases of unknown primary.

Materials and Methods

Six patients (M:F = 5:1, age range 28–56 years) with immunohistochemically proven neuroendocrine liver metastases but inconclusive initial CT work-up were retrospectively analysed. Clinical finding, histopathology, comparative imaging and follow-up were used to validate the results when ethically justified.

Results

68Ga-DOTATATE PET/CT identified the primary tumour in five out of six (83.3 %) patients: pancreas (n = 4) and stomach (n = 1). Out of three patients with indeterminate primary on initial CT, two patients were confirmed by 68Ga-DOTATATE PET/CT. Absence of uptake in indeterminate primary of one patient was later confirmed negative by histopathology. In another three patients with undetected primary on initial CT, primary site was demonstrated in all patients with unsuspected metastases in two patients on 68Ga-DOTATATE PET/ CT. No further work-up was done to confirm the primary in patients with distant metastases. Change of management was observed in three out of six (50 %) patients.

Conclusion

Our small study indicates that 68Ga-DOTATATE PET/CT is a promising diagnostic option in the multimodality approach to neuroendocrine liver metastases of unknown primary origin.

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Acknowledgement

We are grateful to Dr Ewe Seng Ch’ng and all our staff for their assistance in this study. We also thank the Director-General of Health in Malaysia for permission to publish this paper.

Conflict of Interest Statement

Teik Hin Tan, Boon Nang Lee and Siti Zarina Amir Hassan declare that they have no conflict of interest.

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Authors and Affiliations

  1. Nuclear Medicine Department, Hospital Putrajaya, Presint 7, 62250, Putrajaya, Wilayah Persekutuan, Malaysia

    Teik Hin Tan, Boon Nang Lee & Siti Zarina Amir Hassan

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  1. Teik Hin Tan
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  2. Boon Nang Lee
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Correspondence to Teik Hin Tan.

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Tan, T.H., Lee, B.N. & Hassan, S.Z.A. Diagnostic Value of 68Ga-DOTATATE PET/CT in Liver Metastases of Neuroendocrine Tumours of Unknown Origin. Nucl Med Mol Imaging 48, 212–215 (2014). https://doi.org/10.1007/s13139-013-0258-9

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  • DOI: https://doi.org/10.1007/s13139-013-0258-9

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