Detection of "Incidentalomas" on Brain and Body Ga-DOTATOC-PET Scans: A Retrospective Study and Case Illustration

Background/aim: One of the main limitations of standard imaging modalities is microscopic tumor extension, which is often difficult to detect on magnetic resonance imaging (MRI) and computer tomography (CT) in the early stages of the tumor. (68)Ga-DOTA(0)-Phe(1)-Tyr(3)-octreotide positron-emission tomography/computed tomography (Ga-DOTATOC PET/CT) has shown efficacy in detecting lesions previously undiagnosed by neuroimaging modalities, such as MRI or CT, and has enabled the detection of multiple benign tumors (like multiple meningiomas in a patient presenting with a single lesion on MRI) or additional secondary metastatic locations.

Patients And Methods: We retrospectively reviewed data from the Cannizzaro Hospital on brain and body Ga-DOTATOC PET/CT "incidentalomas", defined as tumors missed on CT or MRI scans, but detected on Ga-DOTATOC PET/CT scans. "Incidentalomas" were classified into "brain" and "body" groups based on their location. The standardized uptake values (SUVs) were compared between the two groups.

Results: A total of 61 patients with "incidentalomas" documented on the Ga-DOTATOC PET/CT were identified: 18 patients with 25 brain lesions and 43 patients with 85 body lesions. The mean SUV at baseline was 9.01±7.66 in the brain group and 14.8±14.63 in the body group.

Conclusion: We present the first series on brain and body "incidentalomas" detected on Ga-DOTATOC PET/CT. Whole-body Ga-DOTATOC PET/CT may be considered in selected patients with brain tumors with high expression of somatostatin receptors to assist radiosurgical or surgical planning and, simultaneously, provide accurate follow-up with early detection of potential metastases.