Related Experiment Video
Updated: Mar 6, 2026
10:28
Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT
Published on: January 22, 2018
11.6K
The Wandering Mesenteric Lymph Node: Delayed 68Ga-DOTANOC PET/CT Imaging to Overcome a Potential Pitfall
Lucia Zanoni1, Maurizio Zompatori, Federica Scalorbi
1From the *Nuclear Medicine, and †Radiology, Sant'Orsola University Hospital, Bologna, Italy.
Clinical Nuclear Medicine
|March 7, 2017
Summary
Multiple endocrine neoplasia type 1 patients require careful monitoring for pancreatic neuroendocrine tumor relapse. Ga-DOTANOC PET/CT identified a wandering mesenteric lymph node, highlighting its diagnostic utility in detecting treatment response and potential pitfalls.
Area of Science:
- Nuclear medicine imaging
- Oncology
- Endocrinology
Background:
- Multiple endocrine neoplasia type 1 (MEN1) is a genetic disorder associated with tumors in endocrine glands.
- Pancreatic neuroendocrine tumors (PNETs) are a common manifestation of MEN1, requiring vigilant surveillance for recurrence after treatment.
- Somatostatin analog therapy is a standard treatment for PNETs, often combined with surgical resection.
Observation:
- A patient with MEN1 and suspected PNET relapse underwent gallium-68 DOTA-conjugated somatostatin analogue positron emission tomography/computed tomography (Ga-DOTANOC PET/CT) for restaging.
- Initial and delayed imaging revealed a focal area of intense radiotracer uptake that migrated from the left para-aortic to the paracaval region.
- Previous imaging had shown this lesion in different abdominal locations, including adjacent to the duodenal wall and in the aortocaval region.
Findings:
- Dual time-point Ga-DOTANOC PET/CT successfully identified the mobile nature of the lesion.
- The observed uptake pattern and migration were characteristic of a wandering mesenteric lymph node.
- This finding underscores the importance of dynamic imaging in interpreting PET/CT scans.
Implications:
- Accurate diagnosis of PNET relapse is critical for timely therapeutic adjustments in MEN1 patients.
- Wandering mesenteric lymph nodes can mimic tumor recurrence, posing an interpretation challenge.
- Ga-DOTANOC PET/CT, particularly with dual time-point imaging, enhances diagnostic accuracy by visualizing lesion mobility, preventing misdiagnosis of tumor relapse.
