title: 68Ga-DOTATATE uptake in pineal gland, a rare physiological variant: case series.
abstract: (68)Ga-DOTATATE PET-CT is widely used for the evaluation of neuroendocrine tumours. Knowledge of the physiological distribution of the radiotracer is of critical importance in characterizing focal areas of uptake. In this case series, we report three paediatric cases (average age 4.7 years ± 0.6 SD) with diagnosed advanced stage IV Neuroblastoma. Two had (68)Ga-DOTATATE PET-CT scans and one underwent (68)Ga-DOTATATE PET-MRI scan to assess for suitability of molecular therapy. Focal increased tracer uptake in the pineal gland was noted in all cases with no morphological abnormality on the corresponding CT and MRI scans. The uptake within the gland was thought to be a physiological variant rather than metastases owing to the heterogeneity of somatostatin receptors expression. The pineal gland has been reported to express somatostatin receptors. The physiological distribution of (68)Ga-DOTATATE uptake in the pineal gland is not routinely seen. Furthermore, the possibility of pineal meningioma is very unlikely as pineal meningiomas are very rare and there was no convincing morphological evidence of meningiomas on CT/MRI scan.
authors.affiliation: Institute of Nuclear Medicine, University College Hospitals NHS Trust, 235 Euston Road, London, NW1 2BU, UK. saimarz.dr@gmail.com.
authors.forename: Saima
authors.initials: S
authors.lastname: Riaz
authors.affiliation: Institute of Nuclear Medicine, University College Hospitals NHS Trust, 235 Euston Road, London, NW1 2BU, UK.
authors.forename: Rizwan
authors.initials: R
authors.lastname: Syed
authors.affiliation: Institute of Nuclear Medicine, University College Hospitals NHS Trust, 235 Euston Road, London, NW1 2BU, UK.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Skoura
authors.affiliation: Institute of Nuclear Medicine, University College Hospitals NHS Trust, 235 Euston Road, London, NW1 2BU, UK.
authors.forename: Alshaima
authors.initials: A
authors.lastname: Alshammari
authors.affiliation: Department of Paediatric and Adolescent Oncology, University College London Hospitals NHS Foundation Trust, London, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Gaze
authors.affiliation: Institute of Nuclear Medicine, University College Hospitals NHS Trust, 235 Euston Road, London, NW1 2BU, UK.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Sajjan
authors.affiliation: Institute of Nuclear Medicine, University College Hospitals NHS Trust, 235 Euston Road, London, NW1 2BU, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Halsey
authors.affiliation: Institute of Nuclear Medicine, University College Hospitals NHS Trust, 235 Euston Road, London, NW1 2BU, UK.
authors.forename: Jamshed
authors.initials: J
authors.lastname: Bomanji
mesh_terms: D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D064847:Multimodal Imaging / Q000379:methods; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D009942:Organometallic Compounds / Q000493:pharmacokinetics*; D010870:Pineal Gland / Q000000981:diagnostic imaging* / Q000378:metabolism* / Q000473:pathology; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; C513399:gallium Ga 68 dotatate
keywords: 68Ga-DOTATATE; PET–CT scan; PET–MRI scan; Pineal gland; Somatostatin receptor