DOTATATE PET CT Prep

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Medically reviewed by Dr. Alex Tamm, BMSc, MD (STIR), FRCPC

What is a DOTATATE PET CT Scan?

A DOTATATE PET CT scan is an advanced form of hybrid diagnostic imaging that uses a unique radiotracer which targets somatostatin receptors. DOTATATE PET CT imaging allows for non-invasive functional and molecular characterization of tissue and is often used to detect and treat neuroendocrine tumours. Your practitioner may also refer to this scan as a Somatostatin Receptor (SSTR) PET CT.

How does DOTATATE PET CT work?

During this oncologic PET CT exam, the radiotracer, Gallium-68 DOTATATE, binds to somatostatin receptors. The PET scanner detects where the DOTATATE concentrates, which indicates where specific somatostatin receptors are located in the body.

Our radiologists can use this information to work with your practitioner to:

Diagnose abnormal tumour cells (with specific receptors).
Identify tumours that have come back after treatment.
Localize tumours that have spread to other parts of the body.

DOTATATE PET CT imaging is a hybrid scan that simultaneously captures cross-sectional images from CT and cellular function and metabolism from PET. Combining the two tests during a single session can save patients time and increase diagnostic accuracy.

The Best Test, First

The most common use of DOTATATE PET CT is for imaging neuroendocrine tumours. These tumours can be quite variable and most often arise from the gastrointestinal (GI) tract.

Neuroendocrine tumours are challenging to detect with routine imaging, sometimes leading to a later diagnosis when the cancer is more advanced. DOTATATE PET CT accurately images these tumours, which is crucial for treatment as decisions are impacted by primary tumour location and type.

Is DOTATATE PET CT better than conventional staging scans?

DOTATATE PET CT is one of the most sensitive and accurate diagnostic imaging tests available to assess neuroendocrine tumours compared to conventional anatomical imaging or using a radiotracer called Octreotide. PET CT imaging has been shown to impact treatment decisions often and occasionally open new potential treatment options for patients.

DOTATATE PET imaging is also helpful with:

Gastrointestinal neuroendocrine tumors
Medullary thyroid cancer
Merkel Cell Tumors of Skin
Medulloblastoma
Meningioma
Neuroendocrine tumours – primary unknown
Pancreatic neuroendocrine tumors
Pheochromocytoma
Pulmonary neuroendocrine tumors
Paragangliomas
Neuroblastomas, Ganglioneuroma

If DOTATATE PET CT is so new, why should I choose MIC for my scan?

MIC’s radiologists have experience reading these specialized scans. Our team of dual-certified radiologists (Diagnostic Radiology & Nuclear Medicine) are the same physicians who reported some of the first DOTATATE PET CT studies at the University of Alberta and Royal Alexandra Hospitals and participated in the clinical trials to bring these examinations to Alberta.

What to Expect During a DOTATATE PET CT Scan

You may be asked to change into a gown when you arrive for your exam.
One of our technologists starts an intravenous (IV) line to inject the medications and/or radiotracer.
- You will have to wait for a short time in a private uptake room to allow the radiotracer to circulate through your body.
- You may need to get an IV injection of contrast dye.
The PET CT scanner is a large machine shaped like a doughnut – like a CT or MRI machine. You will lie on an exam table that slides into the doughnut opening. During the scan, you must remain still, as movement can make the scan images blurry.
The time for a PET CT scan varies depending on the type of exam, ranging between approximately 15 to 45 minutes. On average, the entire PET CT appointment can last around 2-3 hours.

How Much Does a DOTATATE PET CT Scan Cost?

MIC uses PET CT imaging in several applications: heart (cardiac) imaging, cancer (oncology) imaging, and brain (neurology) imaging. Currently, the Alberta Health Care Insurance Plan (AHCIP) only covers the cost of PET CT imaging in cardiac applications when performed in a community-based clinic outside the hospital.

Routine use of DOTATATE-PET CT has not been established in Canada, and access is mainly through clinical trials, private healthcare, and registries.

The cost of a DOTATATE PET CT for a cancer application at MIC depends on whether an accompanying diagnostic CT is acquired at the same time. Our team will be happy to speak to you to tailor an exam to your needs.

DOTATATE PET CT (diagnostic CT included) is $TBD
DOTATATE PET (diagnostic CT excluded) is $TBD

Patients are encouraged to talk to their employer or a Benefits Specialist before booking their exam to see if they qualify for extended coverage. Some extended benefits programs or health spending accounts may cover a portion or possibly the entire exam fee.

DOTATATE PET CT FAQs

What are the other PET agents used in DOTATATE PET CT imaging?

At MIC, the radiotracer is Health Canada-approved 68-Gallium DOTATATE. In Canada, 68-Gallium DOTATATE is the only Health Canada-approved SSTR PET tracer currently available outside clinical trials.

Do I have to fast before my scan?

Patients must not eat or drink anything except plain water for a minimum of 4 hours before the appointment.

Patient preparation instructions vary depending on the type of PET CT exam performed. Our booking team will provide detailed instructions when you schedule your exam. It is important to follow the preparation instructions closely, as improper preparation can affect the scan's results or cause the scan to be rescheduled.

If you have any questions or concerns about your preparation, our booking team is happy to help. When you schedule your appointment, our team will review specific exam preparation instructions based on your PET CT study.

Do any medications interfere with my DOTATATE PET scan?

Yes. In general, all short-acting somatostatin analogs (SSAs, e.g., octreotide) should be discontinued for 12 hours before the exam.

If you are on long-acting somatostatin analogs (e.g. octreotide long-acting release, lanreotide), your PET imaging should be scheduled just prior to dosing with long-acting somatostatin analogs (interval of at least 3-4 weeks after administration).

What is theranostics? Is DOTATATE a theranostic agent?

Theranostics (therapeutics + diagnostics = theranostics) is a two-pronged approach to diagnosing and treating cancers through the use of radiotracers.

DOTATATE is an example of a theranostic agent. If the radioactive component is switched to a therapeutic one (i.e. 68Ga is switched to 177Lu), it can specifically target and treat the cancer cells. Before a therapeutic radiotracer is used, patients generally must have a diagnostic scan first, to confirm and assess the ability to target the tumor cells.

Why am I scheduled for two PET scans?

Occasionally, to help with treatment decision-making, your physician may request both DOTATATE and FDG PET CT scans to help characterize the tumours or metastases. The DOTATATE PET scan shows how many receptors the tumours have, while the FDG PET scan shows how metabolically active the cells are.

Each of these PET scans provides complementary information to aid the clinician in making the optimal personalized treatment decision for each individual.

View References

Goldbrunner, R., Stavrinou, P., Jenkinson, M., Saham, F., Mawrin, C., Weber, D., Preusser, M., Minniti, G., Lund-Johansen, M., Lefranc, F., Houdart, E., Sallabanda, K., Le Rhun, E., Nieuwenhuizen, D., Tabatabai, G., Soffietti, R., Weller, M. (2021). EANO Guideline on Meningioma. EANO guideline on the diagnosis and management of meningiomas. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8563316/pdf/noab150.pdf

Hope, T., Bergsland, E., Bozkurt, M., Graham, M., Heaney, A., Herrmann, K., Howe, J., Kulke, M., Kunz, P., Mailman, J., May, L., Metz, D., Millo, C., O’Doriso, S., Reidy-Lagunes, D., Soulen, M., Strosberg, J. (2020). The Journal of Nuclear Medicine. Appropriate Use Criteria for Somatostatin Receptor PET Imaging in Neuroendocrine Tumors. https://s3.amazonaws.com/rdcms-snmmi/files/production/public/Quality/jnm202275_New%20-%20revised.pdf

Learn more about PET CT at MIC:

PET CT Imaging

PET CT Scan for Oncology

PSMA PET CT Imaging

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