title: The 'double pituitary hot spot' sign of skull base meningioma on gallium-68-labelled somatostatin analogue PET.
abstract: Gallium-68 ((68) Ga)-labelled somatostatin analogue imaging by positron emission tomography (PET) is increasingly replacing single photon (such as (111) In-labelled octreotide) imaging in the detection and staging of carcinoid and other neuroendocrine tumours. Among other tissues, pituitary uptake of 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid-octreotate (DOTA-TATE) and other somatostatin analogues is physiological. DOTA-TATE also accumulates in meningiomas, which have a high density of somatostatin receptor expression. The combination of pituitary and skull base meningioma uptake results in a characteristic 'double hot spot' appearance, which indicates the presence of a meningioma. This is a case of a middle-aged woman who underwent (68) Ga-DOTA-TATE PET for confirmation and staging of clinically suspected carcinoid tumour, in whom a skull base meningioma was incidentally discovered. With the increasing use of PET in the management of neuroendocrine tumours - and the not infrequent occurrence of meningiomas - the appearance of meningiomas on somatostatin analogue imaging should be one with which reporting clinicians are familiar.
authors.affiliation: Department of Nuclear Medicine and PET, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia; Medical Imaging Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
authors.forename: W Phillip
authors.initials: WP
authors.lastname: Law
authors.forename: Frank
authors.initials: F
authors.lastname: Fiumara
authors.forename: William
authors.initials: W
authors.lastname: Fong
authors.forename: David J
authors.initials: DJ
authors.lastname: Macfarlane
mesh_terms: D005260:Female; D006801:Humans; D033162:Incidental Findings; D008577:Meningeal Neoplasms / Q000000981:diagnostic imaging*; D008579:Meningioma / Q000000981:diagnostic imaging*; D008875:Middle Aged; D009942:Organometallic Compounds; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D019292:Skull Base Neoplasms / Q000000981:diagnostic imaging*; D013004:Somatostatin
chemical_list: D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; D013004:Somatostatin; C513399:gallium Ga 68 dotatate
keywords: PET; gallium-68; meningioma; somatostatin