68Ga DOTATATE PET/CT Versus 18F-FDG PET/CT for Detecting Intramedullary Hemangioblastoma in a Patient With Von Hippel-Lindau Disease

Abstract

Von Hippel-Lindau disease is an inherited syndrome associated with several benign and malignant tumors such as central nervous system (CNS) hemangioblastoma. Herein, we report a known case of A Von Hippel-Lindau patient with a cerebral hemangioblastoma who was referred for further evaluation because of recent paraparesis. 18F-FDG PET/CT showed no focal uptake in the thoracic spine, which demonstrated increased 68Ga DOTATATE activity, owing to overexpression of somatostatin receptors, suggesting spinal cord hemangioblastoma. This case report indicates the significant role of 68Ga-labeled somatostatin receptor analogs in the diagnosis of hemangioblastoma.

Different manifestations detected with 68Ga-DOTATOC PET/CT in patients with Von Hippel-Lindau disease: A case report

“…However, an intra-pancreatic spleen can mimic an endocrine tumour on 68 Galabeled somatostatin analogs so images should always be correlated with contrastenhanced CT and MRI scans. Various reports have shown the usefulness of 68 Ga-labeled somatostatin analogs in the evaluation of different manifestations, diagnosis, staging, and therapy management of hemangioblastoma [6][7][8]. A previous report enhanced the clinical applications of somatostatin receptor imaging with 68 Ga-labeled somatostatin analogs in detection of VHL-associated retinal hemangioblastomas [9].…”

Unusual 68Ga-DOTATATE Uptake in Primary Nodal Hemangioma of Axillary Lymph Node

“…Although 68 Ga-DOTATATE PET/CT is a highly sensitive modality to detect neuroendocrine tumors, the physicians who evaluate the images must be aware of various physiologic and nontumoral causes that lead to misinterpretation. Most of these pitfalls have been documented before, 5 and a few vascular tumor subtypes were also reported to demonstrate increased uptake of 68 Ga-DOTATATE 6–8 . The expression of somatostatin receptor subtype 2 in growing vascular endothelial cells may be responsible for increased 68 Ga-DOTATATE uptake in those vascular lesions 9 .…”

Re: Extensive Intraspinal Hypermetabolism Caused by Neurobrucellosis Shown on 18F-FDG PET/CT

“…

R adionuclide therapy using a variety of different radioligands, targeting different cell structures such as somatostatin receptors or prostate-specific membrane antigen, has been an evolving field in the nuclear medicine within the last decades. [1][2][3][4][5][6][7][8] This development conducts nuclear medicine toward nuclear oncology. With great interest, we read the report by Moghadam et al 9 The authors report on an accidental oral administration of 177 Lu-PSMA to a patient with hyperthyroidism.

…”

“…Any neurological signs and symptoms should raise the suspicion of abnormal spinal cord uptake. 7 The case of Wu et al 1 The report, however, lacks a dosimetric estimate of the radiation dose involved. Using the data provided by the authors, the skin dose can be estimated using the methodology described by Bonta et al, 2 a previous report of severe skin radiation injury following infiltration of a therapeutic dose of beta-emitting radiopharmaceutical.…”

“…In my opinion, the most important factor to be considered while encountering spinal cord uptake is the clinical setting and examination of the patient. Any neurological signs and symptoms should raise the suspicion of abnormal spinal cord uptake 7 …”