Gallium-68 DOTATATE

Last revised by Dr Sonam Vadera on 17 Mar 2021

Gallium-68 DOTATATE​ (or Ga-68 DOTATATE) is a PET radiotracer that is useful for evaluating primary and metastatic well-differentiated neuroendocrine tumors. It is a form of somatostatin-receptor (SSTR) functional imaging and most often combined with cross-sectional imaging in the form of PET-CT.

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.

There is normal Ga-68 DOTATATE uptake in the pituitary gland, spleen, liver, adrenal glands, and urinary tract 4,5.

The salivary glands and thyroid show faint to mild homogeneous uptake 4,5.

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Cases and figures

  • Case 1
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  • Case 2: physiological uptake at the uncinate process of pancreas
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