The value of 68 Gallium-DOTATATE PET/CT in sinonasal neuroendocrine tumor management: A case series

Abstract

Background: ⁶⁸ Gallium-DOTATATE (⁶⁸ Ga-DOTATATE) is a somatostatin analog used as a PET tracer to successfully identify neuroendocrine tumors (NETs). Due to the rarity of sinonasal NETs, there are few recommendations for ⁶⁸ Ga-DOTATATE imaging in these patients.

Methods: We discussed the impact of ⁶⁸ Ga-DOTATATE imaging on the management of six sinonasal NET cases and reviewed existing literature.

Results: ⁶⁸ Ga-DOTATATE PET/CT revealed an unknown primary in one case and identified metastatic disease in a primary sinonasal small cell neuroendocrine carcinoma (SNEC) patient missed on conventional imaging. In two esthesioneuroblastoma (ENB) patients, ⁶⁸ Ga-DOTATATE detected abnormal radiotracer uptake not present on 18F-FDG PET/CT and identified a patient for treatment with ¹⁷⁷ Lu-DOTATATE.

Conclusions: This is the one of the first few reports, and the largest series to our knowledge, demonstrating the utility of ⁶⁸ Ga-DOTATATE imaging for primary sinonasal SNEC and ENB. Further study is required to determine its role in sinonasal NET management.

Keywords: diagnostic imaging; esthesioneuroblastoma; gallium dotatate; neuroendocrine tumor; sinonasal small cell neuroendocrine tumor; somatostatin analog.