Pediatric imaging experience with Ga-68 NETSPOT

Objectives: Gallium-68 Dotatate (NETSPOT) is a PET radiotracer for use in the localization of somatostatin receptor positive neuroendocrine tumors (NETs). NETs are rare noncancerous or cancerous tumors that develop in the hormone-producing cells of the body's neuroendocrine system that have receptors for somatostatin. Gallium- 68 dotatate, a positron-emitting analogue of somatostatin that binds to somatostatin receptors. NET's are extremely rare in children and adolescence, with an incidence rate of 2.8 per million under the age of 30. Because of the rarity of NET's in children and adolescence the amount of experience in imaging such patients are extremely limited. The objective of this abstract presentation is to outline our experience with imaging pediatric patients suspected or confirmed of having a somatostatin receptor positive neuroendocrine tumor (NET). Methods: A total of 5 pediatric patients were imaged. Pediatric patient preparation involved no dietary restrictions. Patients were instructed to pause somatostatin / octreotide therapy. Patients were injected with 0.054 mCi/kg (2 MBq/kq) Gallium-68 NETSPOT, maximum dose of 5.4 mCi (200 MBq) mCi, minimum dose 2 mCi (74MBq). Patients were well hydrated prior to administration and asked to void frequently, and to continue this for several hours after the exam. Imaging commenced approximately 60 minutes post administration. Imaging was obtained from skull base to proximal thigh for 5 minutes per bed position using 2D acquisition. A low-dose non-contrast CT was performed for anatomical localization and attenuation correction. Results: Patients age ranged from 5 to 17 years old with a mean of 12; 4 females and 1 male. All patients had suspicion or confirmation of NET's by clinical presentation and by other diagnostic imaging modalities. The table below outlines the results of the 5 patients. Patient 1: Right lower lobe lung mass on CT, NETSPOT showed intense uptake in the area of the mass. Patient 2: History of paraganglioma with a left adrenal mass on MR, NETSPOT imaging showed abnormal left adrenal gland uptake consistent with recurrence. Patient 3: Carcinoid tumor of appendix was resected, NETSPOT imaging showed no evidence of metastatic disease. Patient 4: History of MEN 1 syndrome, NETSPOT imaging showed no evidence of malignancy. Patient 5: History of pheochromocytoma of left adrenal gland, s/p left adrenalectomy. NETSPOT imaging showed no evidence of metastasis. Figure 1 shows images from patient 1