Gallium-68 DOTATATE

Last revised by Mostafa El-Feky on 29 Sep 2023

Gallium-68 DOTATATE​​ (or Ga-68 DOTATATE) is a PET radiotracer that is a form of somatostatin-receptor (SSTR) functional imaging. It is most commonly used for evaluating primary and metastatic well-differentiated neuroendocrine tumors. There are also emerging uses for evaluating other somatostatin-expressing conditions, such as meningiomas or sarcoidosis 5.

Gallium-68 DOTATATE is synthesized from three main components:

  1. gallium (Ga) radiotracer

  2. linked, via a chemical macrocyclic chelator, known as DOTA (or tetraxetan; IUPAC name: 1,4,7,10-tetraazacyclododecane-tetraacetic acid)

  3. to the short-chain peptide Tyr3-octreotate (TATE)

Ga-68 DOTATATE​​ has shown improved accuracy for detection relative to indium-111 pentetreotide SPECT-CT 1​. It binds SSTR subtype 2 and binds 100 times more avidly than indium-111 pentetreotide 2.

There are other forms:

  • DOTATOC: DOTA-d-Phe1-Tyr3-octreotide

  • DOTANOC: DOTA-1-Nal3-octreotide

These have an affinity for different somatostatin receptors, SSTR subtypes 3 and 5 and SSTR subtype 5, respectively 3.

Physiological high-intensity uptake is typically seen in the spleen 4,5.

The liver, uncinate process of the pancreas, pituitary gland, adrenal glands and urinary tract typically demonstrates moderate-intensity uptake 4,5.

The salivary and thyroid glands typically only show mild uptake 4,5.

In contrast to FDG PET, there is little tracer activity within the brain. 

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Cases and figures

  • Case 1: normal physiological uptake and abdominal metatsatic lymph node
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  • Case 2: physiological uptake at the uncinate process of pancreas
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  • Case 3: bronchial carcinoid tumor
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  • Case 4: jugulotympanic paraganglioma
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  • Case 5: thymoma
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