68Ga-DOTATATE PET/CT versus 18F-FDG PET/CT for detecting intramedullary hemangioblastoma in a patient with Von Hippel-Lindau Disease

Background: Von Hippel-Lindau disease (VHL) is an inherited syndrome which is associated with several benign and malignant tumors such as central nervous system (CNS) hemangioblastoma, renal cysts and tumors, pancreatic cysts and tumors, pheochromocytomas and endolymphatic sac tumors.Presentation: Herein, we report a 27-year-old man with a history of VHL disease and a known cerebral hemangioblastoma who was referred for further evaluation because of recent paraparesis. 68Ga-DOTATATE as well as 18F-FDG whole-body PET/CT scans, were done. A focal lesion in the thoracic spinal cord, at the level of the 5th thoracic vertebra, was noted without any abnormal 18F-FDG uptake but high 68Ga-DOTATATE avidity due to overexpression of somatostatin receptors, suggesting spinal cord hemangioblastoma. Fused PET/CT images also revealed a significantly 68Ga-DOTATATE avid lesion (SUV max=10.49) in the right occipital lobe without any discernible uptake on 18F-FDG PET/CT images.Discussion and conclusion: Among imaging modalities, 68Ga-DOTATATE PET/CT with high accuracy has a significant role in the evaluation of different manifestations, diagnosis, staging as well as therapy management of these tumors. The accuracy of this method is based on the molecular characteristics of tumoral cells and especially somatostatin receptors (SSTR) overexpression by hemangioblastomas. This case report indicates the significant role of 68Ga-labeled somatostatin receptor analogs in the diagnosis of hemangioblastoma.

Keywords:

68Ga-DOTATATE PET/CT , 18F-FDG PET/CT , Von Hippel-Lindau disease , hemangioblastomas