Abstract
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Objectives: We evaluated normal pituitary gland uptake of 68Ga‐ DOTA‐DPhe1, Tyr3‐octreotate (DOTATATE) using positron emission tomography (PET) / computed tomography (CT) to assess correlations with patient age, gender, and body mass index (BMI). We hypothesized that normal somatostatin receptor (SSTR) uptake would decline with age as it has been reported that normal pituitary volume and endocrine function declines with age.
Methods: Patients who underwent clinical DOTATATE PET/CT imaging were included in this IRB-approved retrospective study. Using MIM 6.9.3 (MIM Software Inc., Cleveland, US), whole pituitary gland regions of interest (ROI) were manually created. Final ROIs were formed by then removing all voxels within the manual ROI which were less than 25% of the maximum standardized uptake value (SUVMAX). Pituitary gland total lesion receptor content (TLRC), SUVMAX, and SULMAX were extracted from each ROI. Extracted PET metrics were then correlated with patient age, gender, and BMI. Data are reported using correlation coefficients and median (IQR). Data analyses were performed using SPSS. Results: Seventy-two patients (35M/37W; mean age 53.2±21.8 years) underwent DOTATATE PET/CT imaging and were eligible for pituitary gland analysis. Median (IQR) TLRC was 4.90 (2.80-8.76), 5.89 (3.02-9.9), and 6.47 (3.21-12.19) for normal, overweight, and obese patients, respectively (p = 0.054; Fig 1A). The p-value was found to be 0.02 between normal and obese. Median (IQR) SUVMAX was 10.6 (4.8-20.1), 13.8 (7.7-22.6), and 13.1 (4.8-34.4) for normal, overweight, and obese patients, respectively (p = 0.10; Fig 1B). The p-value was found to be 0.02 between normal and obese. Median (IQR) SULMAX was 8.2 (3.3-13.2), 8.7 (5.0-16.9), and 7.7 (2.0-17.9) for normal, overweight, and obese patients, respectively (p = 0.260; Fig 1C). The p-value was found to be 0.75 between normal and obese. Females showed pituitary gland TLRC of 5.93 (3.55-12.19) versus 5.62 (2.80-8.92) for males (p = 0.15; Fig 1C). Females showed pituitary gland SUVMAX of 13.1 (4.8-34.4) versus 12.3 (7.1-25.4) for males (p = 0.06; Fig 2C). Females showed pituitary gland SULMAX of 7.7 (2.0-17.9) versus 8.7 (4.8-16.9) for males (p = 0.18; Fig 1C). Pituitary DOTATATE TLRC, SUVMAX, and SULMAX were stable with age (p = 0.51, r2 = 0.01; Fig 1A, p = 0.590, r2 = 0.00; Fig 2A, and p = 0.51, r2 = 0.00; Fig 3A, respectively). Conclusions: Pituitary gland TLRC and SUVMAX tend to increase with increasing BMI. Age and gender were not associated with significant differences in pituitary DOTATATE uptake. SUL values were similar across body mass and gender suggesting DOTATATE uptake to be particularly low in white adipose tissue. Our findings provide potentially important implications for the interpretation of quantitative 68Ga‐DOTATATE uptake in the pituitary gland.
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