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68Ga-DOTA-peptides PET/MRI in pancreatico-duodenal neuroendocrine tumours: a flash pictorial essay on assets and lacks

  • Pictorial Essay
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Abstract

Purpose

PET with radiolabeled somatostatin receptors (SSTR) analogues, such as 68Ga-DOTATOC, is commonly used in all stages of gastroenteropancreatic neuroendocrine tumours (GEP-NETs). Magnetic resonance Imaging (MRI) has excellent soft-tissue contrast and it is mainly applied in this oncological setting for assessing liver disease. Simultaneous PET/MRI scanners allow the combined acquisition of PET and MRI data with improved patient comfort and reduced radiation dose. The aim of the present pictorial essay is to highlight the assets and limits of fully hybrid PET/MRI in the field of GEP-NETs, presenting significant clinical cases performed in our Centre.

Technique and findings

PET/MRI protocol: simultaneous PET/MRI acquisition started approximately 60 min after 68Ga-DOTATOC tracer injection; MR localizer was performed to define the number of table positions (PET-FOV) for PET/MRI whole-body acquisition. A dedicated MRI protocol was performed on the abdomen, following the whole-body PET/MRI scan.

Conclusion

68Ga-DOTATOC PET/MRI combines the high sensitivity and specificity of 68Ga-DOTATOC PET tracer and MR high-quality imaging, especially for the liver. The clinical setting of GEP-NETs represents an interesting setting of application of this imaging technique, although the pros and cons should be taken into account until further methodological improvements will occur, especially for the characterization of lung findings.

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Acknowledgements

Signa PET/MRI system (GEMS, Wakesha, Wisconsin, USA) used in the present work has been purchased with funding from Italian Ministero della Salute.

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Authors and Affiliations

  1. Vita-Salute San Raffaele University, Milan, Italy

    P. Mapelli, S. Partelli, V. Andreasi, M. Falconi, F. De Cobelli & M. Picchio

  2. Nuclear Medicine Department, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132, Milan, Italy

    P. Mapelli, F. Fallanca, L. Gianolli & M. Picchio

  3. Radiology Department, IRCCS San Raffaele Scientific Institute, Milan, Italy

    G. Ironi & F. De Cobelli

  4. Pancreatic Surgery Unit, Pancreas Translational & Clinical Research Centre, IRCCS San Raffaele Scientific Institute, Milan, Italy

    S. Partelli, F. Muffatti, V. Andreasi & M. Falconi

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  1. P. Mapelli
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Contributions

Mapelli P: content planning, project development, imaging and clinical data collection, writing, and editing. Ironi G: imaging data collection, editing, and revision. Fallanca F: imaging data collection, editing, and revision. Partelli S: clinical data collection, editing, and revision. Muffatti F: clinical data collection, editing, and revision. Andreasi V: clinical data collection, editing, and revision. Gianolli L: editing and revision. Falconi M: clinical data collection, editing, and revision. De Cobelli F: content planning, imaging data collection, editing, and revision. Picchio M: content planning, project development editing, and revision.

Corresponding author

Correspondence to M. Picchio.

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Conflicts of interest

Mapelli P, Ironi G, Fallanca, Partelli S, Muffatti F, Andreasi V, Gianolli L, Falconi M, De Cobelli F, and Picchio M received support for travel expenses for attending a meeting from GE Healthcare. GE Healthcare had no involvement in writing this manuscript.

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All performed procedures were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Mapelli, P., Ironi, G., Fallanca, F. et al. 68Ga-DOTA-peptides PET/MRI in pancreatico-duodenal neuroendocrine tumours: a flash pictorial essay on assets and lacks. Clin Transl Imaging 7, 363–371 (2019). https://doi.org/10.1007/s40336-019-00341-4

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