Sacral Insufficiency Fracture on 68Ga-DOTATATE PET/CT

Abstract

68Ga-DOTATATE PET/CT is an important tool for imaging neuroendocrine tumors, including skeletal metastases. However, false-positive results can occur in inflammatory pathologies such as sacral insufficiency fracture. We report the case of a 47-year-old man who was diagnosed with a neuroendocrine tumor of the pancreas. 68Ga-DOTATATE PET/CT showed 68Ga-DOTATATE uptake at the right side of the sacrum. Afterward, MRI made the diagnosis of sacral insufficiency fracture.

Incidental Detection of Sacral Insufficiency Fracture on 68Ga-FAPI PET/MR

“…4 Studies have reported that 18 F-FDG and 68 Ga-DOTA-TATE uptake can also be seen in insufficiency fractures. 3,5 But 68 Ga-FAPI PET revealed sacral insufficiency fracture better than 18 F-FDG in this patient. A previous study pointed out that 18 F-FDG PET demonstrated no uptake or only slightly increased uptake in fractures caused by osteoporosis.…”

“…Radiotherapy is one of the most important risk factors of insufficiency fracture for patients with cancer 4 . Studies have reported that 18 F-FDG and 68 Ga-DOTA-TATE uptake can also be seen in insufficiency fractures 3,5 . But 68 Ga-FAPI PET revealed sacral insufficiency fracture better than 18 F-FDG in this patient.…”

18F-MFBG PET/CT Is an Effective Alternative of 68Ga-DOTATATE PET/CT in the Evaluation of Metastatic Pheochromocytoma and Paraganglioma

“…Increased 68 Ga-DOTATATE accumulation can occurs in not only PPGL but many types of nonneuroendocrine malignancies [26][27][28][29][30][31][32] and even nonmalignant lesions. [33][34][35][36][37][38][39] The uptake by these non-PPGL etiologies can lead to false-positive results of 68 Ga-DOTATATE PET/CT, whereas 18 F-MFBG imaging conceivably will have less false-positive uptake based on the well-known results of 123/131 I-MIBG that have similar, if not the same, biodistribution of 18 F-MFBG.…”

Solitary Pulmonary Perivascular Epithelial Cell Tumor Mimicking Pulmonary Metastasis on 68Ga-DOTATATE PET/CT in a Patient With Pancreatic Neuroendocrine Tumor

“…Recent studies described an intriguing case of a pulmonary carcinoid tumor with extensive skin, subcutaneous, thyroid, and intramuscular metastases. 4 Most of these lesions present with moderate to intense DOTATATE uptake. Metastatic lung neuroendocrine tumors may exhibit heterogeneity on DOTATATE.…”

“…DOTATATE uptake is seen in different clinical entities and in various types of cancer. Recent studies described an intriguing case of a pulmonary carcinoid tumor with extensive skin, subcutaneous, thyroid, and intramuscular metastases 4 . Most of these lesions present with moderate to intense DOTATATE uptake.…”