False-Positive 68Ga-DOTATATE Uptake in a Uterine Subserosal Fibroid Mimicking Mesenteric Neuroendocrine Tumor

Abstract

68Ga-DOTATATE PET/CT is a highly sensitive and specific imaging modality in detecting neuroendocrine tumors. False-positive DOTATATE uptake poses diagnostic challenges. False-positive uptake in a uterine fibroid is the third most common location. We report the case of a 45-year-old woman with clinical concern for possible neuroendocrine tumor showing moderate focal DOTATATE uptake, which was initially thought of to be localized to mesentery on PET/CT images but was subsequently localized to a subserosal uterine fibroid following MRI. Patient underwent hysterectomy, further confirming that the uterine myometrial uptake is within the subserosal fibroid.

Molecular Imaging in Gynecology: Beyond Cancer

“…3) (35). Finally, incidental uptake in uterine fibroids has been observed with several other PET tracers-i.e., [ 68 Ga]Ga-DOTATATE, Al[ 18 F]F-NOTA-FAPI, and [ 18 F]NaF-though more comprehensive follow-up studies have yet to be performed (36)(37)(38). In the end, it is unlikely that molecular imaging will play a key standalone role in the detection of uterine fibroids given the efficacy of existing diagnostic methods.…”