![]() ![]() In fact, in all key aspects (resolution, imaging time, radiation dose, sensitivity, and resultant change in clinical management), 68Ga-DOTATATE is superior to 111In-pentetreotide and should, therefore, be used whenever possible. Aside from the improved resolution of positron emission tomography (PET) over planar as well as SPECT gamma camera imaging, the imaging protocol is also much more favorable as the whole-body scan is done at 60 min post injection. In June 2016, 68Ga-DOTATATE (NetSpot, Advanced Accelerator Applications ) was FDA approved, thereby providing a PET-imaging alternative to the long-used 111In-pentetreotide ( Figs. Three peptides based on this concept include DOTA-TATE, DOTA-TOC, and DOTA-NOC. ![]() The next generation of imaging agents used the positron-emitting isotope Gallium-68 ( 68Ga) bound to either octreotide or octreotate using the DOTA-linker ( 6). Even further delayed imaging is sometimes necessary and the patient is requested to have regular bowel movements during this time (with the use of over-the-counter laxatives if needed) to increase the specificity of the scan. The imaging protocol is somewhat cumbersome as the radiopharmaceutical injection is followed 24 and (often) 48 h afterward with whole-body planar imaging with or without SPECT/CT. In-111 allows for gamma-imaging and this has been the mainstay of nuclear imaging of NETs since the 1980s. Historically, the first approach to both nuclear imaging and therapy of NETs was with Indium-111 DTPA-octreotide (or In111-pentetreotide Octreoscan TM) ( 5). ![]()
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