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

This systematic review aimed to explore the currently reported false positive findings of Gallium-68 (⁶⁸Ga)-1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid Tyr3-octreotide (⁶⁸Ga-DOTATOC). PubMed, Web of Science, and Scopus databases were used to conduct a systematic search and were updated until March 4, 2024. Three authors independently screened the titles and abstracts of the retrieved articles and selected the articles based on the inclusion and exclusion criteria. In a qualitative analysis of 42 included research articles involving 601 patients, 219 false positive findings were identified and categorized. Non-oncologic etiologies predominated, constituting 50.2% of pitfalls, followed by benign oncologic (27.4%) and malignant neoplasms (22.4%). Anatomically, the abdomen was the most common site for pitfalls (30.6%), followed by the musculoskeletal (22.4%), head and neck (20.5%), and pelvic (14.6%) regions. Chest region findings were least frequent, accounting for only 11.9%. This study elucidates potential false positive findings, predominantly occurring in the abdominal and head-neck regions-primary sites for meningiomas and neuroendocrine tumors (NETs). Understanding these false-positive findings is crucial for accurate diagnosis. Furthermore, recognizing these pitfalls may lead to novel applications of ⁶⁸Ga-DOTATOC beyond its conventional use in evaluating NETs and meningiomas, potentially expanding its current utility.