title: The value of somatostatin receptor imaging with In-111 Octreotide and/or Ga-68 DOTATATE in localizing Ectopic ACTH producing tumors.
abstract: OBJECTIVE
  We aimed to evaluate the value of somatostatin receptor imaging (SRI) with In-111 octreotide and Ga-68 DOTATATE in localizing ectopic ACTH producing tumors.
  
  
  METHODS
  Nineteen patients who had In-111 octreotide somatostatin receptor scintigraphy (SRS) and/or Ga-68 DOTATATE PET-CT to localize ectopic ACTH producing tumors between the years 2000 and 2012 were included retrospectively in our study. The results of SRI were compared with clinical onset, radiological findings and surgical data of the patients.
  
  
  RESULTS
  Sixteen In-111 octreotide SRS and five Ga-68 DOTATATE PET-CT were performed in 19 patients. In eight out of 19 patients, ectopic ACTH secretion site could be detected. In five patients, SRS showed pathologic uptake. In four of these patients, surgery revealed pulmonary carcinoid tumors and in one patient pancreatic neuroendocrine tumor. In one patient, Ga-68 DOTATATE PET-CT revealed pathologic uptake in lung nodule which came out to be pulmonary carcinoid tumor. In another patient who had resection of metastases of atypical carcinoid tumor prior to scans, new metastatic foci were detected both with SRS and Ga-68 DOTATATE PET-CT imaging. In one patient, although SRS was negative, CT which was performed three years later showed a lung nodule diagnosed as pulmonary carcinoid tumor. In 11 patients, ectopic ACTH secretion site could not be detected. In 10 of those patients, scintigraphic and radiological imaging did not show any lesions and in one patient, Ga-68 DOTATATE PET-CT was false positive.
  
  
  CONCLUSIONS
  SRI has a complementary role with radiological imaging in localizing ectopic ACTH secretion sites. PET-CT imaging with Ga-68 peptide conjugates is a promising new modality for this indication.
  
  
  BACKGROUND
  None declared.
authors.affiliation: İstanbul University İstanbul Medical Faculty, Nuclear Medicine Department, İstanbul, Turkey.
authors.forename: Zeynep Gözde
authors.initials: ZG
authors.lastname: Özkan
authors.forename: Serkan
authors.initials: S
authors.lastname: Kuyumcu
authors.forename: Deniz
authors.initials: D
authors.lastname: Balköse
authors.forename: Berker
authors.initials: B
authors.lastname: Ozkan
authors.forename: Nihat
authors.initials: N
authors.lastname: Aksakal
authors.forename: Ebru
authors.initials: E
authors.lastname: Yılmaz
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Sanlı
authors.forename: Cüneyt
authors.initials: C
authors.lastname: Türkmen
authors.forename: Ferihan
authors.initials: F
authors.lastname: Aral
authors.forename: Işik
authors.initials: I
authors.lastname: Adalet
keywords: Cushing syndrome; ectopic ACTH Syndrome; gallium radioisotopes; indium-111-octreotide; positron-emission tomography/computed tomography; scintigraphy; somatostatin receptor