False Positive Findings of ⁶⁸Ga-DOTATOC PET/CT: A Systematic Review

Area of Science:

• Nuclear Medicine
• Radiopharmaceuticals
• Diagnostic Imaging

Background:

• Gallium-68 DOTATOC (⁶⁸Ga-DOTATOC) is widely used for diagnosing neuroendocrine tumors (NETs).
• False positive findings can lead to misdiagnosis and unnecessary interventions.
• Systematic review of reported false positive findings is needed to improve diagnostic accuracy.

Purpose of the Study:

• To systematically review and categorize reported false positive findings of ⁶⁸Ga-DOTATOC.
• To identify common sites and etiologies of these false positive results.
• To enhance the understanding and clinical application of ⁶⁸Ga-DOTATOC.

Main Methods:

• Systematic search of PubMed, Web of Science, and Scopus databases updated until March 4, 2024.
• Independent screening of titles and abstracts by three authors based on inclusion/exclusion criteria.
• Qualitative analysis of 42 included articles involving 601 patients.

Main Results:

• A total of 219 false positive findings were identified and categorized.
• Non-oncologic etiologies (50.2%) predominated, followed by benign (27.4%) and malignant neoplasms (22.4%).
• Abdomen (30.6%) and head/neck (20.5%) were the most common sites for false positives, often related to meningiomas and NETs.

Conclusions:

• False positive findings in ⁶⁸Ga-DOTATOC imaging are frequent and diverse.
• Understanding these pitfalls is crucial for accurate diagnosis and patient management.
• Recognizing false positives may expand the utility of ⁶⁸Ga-DOTATOC beyond NETs and meningiomas.