⁶⁸Gallium DOTATATE and Neuroblastoma Restaging and Response to Therapy Evaluation

Introduction: Neuroblastoma evaluation has been traditionally performed with iodine 123 MIBG and in certain select cases it may require an additional evaluation with FDG PET. Newer PET agents have been reported to be superior to MIBG SPECT imaging and offer a higher sensitivity and accuracy. ⁶⁸Gallium DOTATATE is FDA approved and reported to have sensitivity and specificity in the high 90’s in the evaluation of Neuroblastoma patients although data is sparse.

Methods: As international flights amid the COVID pandemic were halted, iodine 123 MIBG shipping became tenuous and we evaluated our neuroblastoma patients for follow-up studies with ⁶⁸Gallium DOTATATE as it was produced loco regionally.

Results: We imaged five follow-up neuroblastoma patients with DOTATATE PET. Median age was 39 months (3 females and 2 males). Four of these patients also had a baseline DOTATATE PET. Four scans had positive findings on follow-up imaging. Only one patient had adverse cytogenetics. Four patients were in the high-risk group. No special preparation was required for the DOTATATE scans in comparison to the MIBG studies. Radiation dosimetry is also more favorable with DOTATATE PET compared to MIBG scans.

Conclusions: ⁶⁸Gallium DOTATATE PET imaging in neuroblastoma restaging and response to therapy evaluation is feasible and offers several advantages which include high spatial resolution, high sensitivity and specificity, no special preparation and a relatively favorable dosimetry profile compared to traditional MIBG scans.

• Download figure
• Open in new tab
• Download powerpoint