Pediatric applications of Dotatate: early diagnostic and therapeutic experience

Pediatr Radiol. 2020 Jun;50(7):882-897. doi: 10.1007/s00247-020-04688-z. Epub 2020 Jun 3.

Abstract

In recent years, new somatostatin receptor agents (SSTRs) have become available for diagnostic imaging and therapy in neuroendocrine tumors. The novel SSTR ligand DOTA-DPhel-Tyr3-octreotate (Dotatate) in particular can be linked with 68Gallium for diagnostic imaging purposes, and with the β-emitter 177Lutetium for radiotherapy in the setting of neuroendocrine tumors. Dotatate imaging offers distinct advantages in the evaluation of neuroendocrine tumors compared to standard techniques, including greater target-to-background ratio and lesion conspicuity, high sensitivity/specificity, improved spatial resolution with positron emission tomography (PET)/CT or PET/MR, and decreased radiation exposure. Although currently off-label in pediatrics, Dotatate theranostics in children are being explored, most notably in the setting of neuroblastoma and hereditary neuroendocrine syndromes. This article provides a multicenter case series of Dotatate imaging and therapy in pediatric patients in order to highlight the spectrum of potential clinical applications.

Keywords: Children; Dotatate; Neuroendocrine tumor; Nuclear medicine imaging; Somatostatin receptor agents; Theranostics.

Publication types

  • Review

MeSH terms

  • Child
  • Contrast Media*
  • Humans
  • Multimodal Imaging*
  • Neuroblastoma / diagnostic imaging*
  • Neuroblastoma / metabolism
  • Neuroblastoma / radiotherapy*
  • Neuroendocrine Tumors / diagnostic imaging*
  • Neuroendocrine Tumors / metabolism
  • Neuroendocrine Tumors / radiotherapy*
  • Octreotide / analogs & derivatives*
  • Octreotide / therapeutic use
  • Organometallic Compounds / therapeutic use*
  • Radiopharmaceuticals
  • Receptors, Somatostatin / metabolism
  • Sensitivity and Specificity

Substances

  • Contrast Media
  • Organometallic Compounds
  • Radiopharmaceuticals
  • Receptors, Somatostatin
  • gallium Ga 68 dotatate
  • lutetium Lu 177 dotatate
  • Octreotide