⁶⁸Ga-DOTATATE Uptake in COVID-19 Pneumonia: A Non-Neoplastic False Positive

 

 Permissions and Reprints

Abstract

In the detection and characterization of neuroendocrine tumors (NETs), the NETSPOT ⁶⁸Ga-DOTATATE positron emission tomography/computed tomography (PET/CT) utilizes a somatostatin analog to capture whole body imaging of somatostatin receptors. Here, we report a rare case of incidental coronavirus disease 2019 (COVID-19) detection using ⁶⁸Ga-DOTATATE PET/CT for a 48-year-old patient with COVID-19 who presented to our nuclear medicine department for oncologic and neuroendocrine indications. Current maximal intensity project image from 68Ga-DOTATATE PET/CT demonstrated numerous hypermetabolic foci in the upper abdominal lymph nodes, consistent with somatostatin-avid pancreatic islet cell neoplasm. Radiotracer uptake corresponding to the anatomic infiltrates was also seen in the bilateral pneumonia. With the rise of worldwide COVID-19 cases, and the continued use of NETSPOT for somatostatin avid neoplasms, it is imperative that diagnostic measures of this disease are clearly understood. This case highlights the importance of including COVID-19 on the differential diagnosis when radiotracer uptake appears in ⁶⁸Ga-DOTATATE PET/CT.

Publication History

Article published online:
19 July 2022

© 2022. World Association of Radiopharmaceutical and Molecular Therapy (WARMTH). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

• References

• 1 CDC COVID Data Tracker. https://covid.cdc.gov/covid-data-tracker/#datatracker-home . Accessed April 3, 2022
  Google Scholar
• 2 Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, Evaluation, and Treatment of Coronavirus (COVID-19). In: StatPearls. Treasure Island (FL): StatPearls Publishing;
  Google Scholar
• 3 Fang Y, Zhang H, Xie J. et al. Sensitivity of chest CT for COVID-19: comparison to RT-PCR. Radiology 2020; 296 (02) E115-E117
  CrossrefPubMedGoogle Scholar
• 4 Albano D, Bertagna F, Bertoli M. et al. Incidental findings suggestive of COVID-19 in asymptomatic patients undergoing nuclear medicine procedures in a high-prevalence region. J Nucl Med 2020; 61 (05) 632-636
  CrossrefPubMedGoogle Scholar
• 5 Qin C, Liu F, Yen T-C, Lan X. ¹⁸F-FDG PET/CT findings of COVID-19: a series of four highly suspected cases. Eur J Nucl Med Mol Imaging 2020; 47 (05) 1281-1286
  CrossrefPubMedGoogle Scholar
• 6 Lütje S, Marinova M, Kütting D, Attenberger U, Essler M, Bundschuh RA. Nuclear medicine in SARS-CoV-2 pandemia: 18F-FDG-PET/CT to visualize COVID-19. Nucl Med (Stuttg) 2020; 59 (03) 276-280
  Google Scholar
• 7 Barrio M, Czernin J, Fanti S. et al. The impact of somatostatin receptor-directed PET/CT on the management of patients with neuroendocrine tumor: a systematic review and meta-analysis. J Nucl Med 2017; 58 (05) 756-761
  CrossrefPubMedGoogle Scholar
• 8 Deng Y, Lei L, Chen Y, Zhang W. The potential added value of FDG PET/CT for COVID-19 pneumonia. Eur J Nucl Med Mol Imaging 2020; 47 (07) 1634-1635
  CrossrefPubMedGoogle Scholar
• 9 Das KM, Lee EY, Langer RD, Larsson SG. Middle east respiratory syndrome coronavirus: what does a radiologist need to know?. AJR Am J Roentgenol 2016; 206 (06) 1193-1201
  CrossrefPubMedGoogle Scholar
• 10 Hofman MS, Lau WFE, Hicks RJ. Somatostatin receptor imaging with 68Ga DOTATATE PET/CT: clinical utility, normal patterns, pearls, and pitfalls in interpretation. Radiographics 2015; 35 (02) 500-516
  CrossrefPubMedGoogle Scholar