Gallium-68 DOTATATE PET-CT is requested for a patient with a suspected neuroendocrine tumour (NET). Compared to 68Ga-DOTATATE, somatostatin receptor scintigraphy (octreotide scan), and 18F-FDG PET, the correct statement regarding NET imaging is:

• A 18F-FDG PET is the preferred initial imaging for well-differentiated low-grade NETs
• B Octreotide scan has higher sensitivity than 68Ga-DOTATATE for small lesions
• C 68Ga-DOTATATE is preferred only for poorly differentiated NETs (Grade 3)
• D 68Ga-DOTATATE PET is superior to octreotide scan for well-differentiated NETs (Grade 1–2) ✓

Explanation

68Ga-DOTATATE PET-CT has replaced conventional octreotide scintigraphy (SRS) for well-differentiated somatostatin receptor-positive NETs (Grade 1–2), offering higher spatial resolution, superior sensitivity (>90% vs. ~75% for SRS), and the ability to detect smaller lesions. 18F-FDG PET is reserved for poorly differentiated, high-grade NETs (Ki-67 >20%) which tend to be FDG-avid but DOTATATE-negative. Octreotide scan is inferior to DOTATATE in resolution and sensitivity.

Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.

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