Department of Neurosurgery, State University of New York, Buffalo, New York, USA.
Department of Neuro-Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA.
BMJ Case Rep. 2022 Apr 29;15(4):e247540. doi: 10.1136/bcr-2021-247540.
Gallium 68 (Ga) 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid labelled octreotate ([Ga]Ga-DOTA-TATE) positron emission tomography (PET) is an established imaging technique for identifying tumours of neuroendocrine origin and meningiomas; the radiotracer binds to somatostatin receptor type 2 (SSTR2), which is richly expressed by these malignancies. Here, we present a rare case hinting at novel ischaemic stroke detection by [Ga]Ga-DOTA-TATE PET scan. The scan was performed 14 days post resection of an atypical meningioma with the intention to assess the extent of residual tumour for radiosurgical treatment of the operative cavity. Surprisingly, the [Ga]Ga-DOTA-TATE PET-avid region corresponded to an area of perioperative subacute ischaemic stroke detected by MRI. This case corroborates the two previously reported cases of incidental detection of ischaemic stroke during routine [Ga]Ga-DOTA-TATE PET imaging, collectively suggesting the need for caution when interpreting the imaging findings. A possible underlying mechanism for [Ga]Ga-DOTA-TATE uptake in stroke is increased SSTR2 expression by macrophages recruited into infarcted tissue.
镓 68（Ga）1、4、7、10-四氮杂环十二烷-1、4、7、10-四乙酸标记奥曲肽（[Ga]Ga-DOTA-TATE）正电子发射断层扫描（PET）是一种已确立的成像技术，用于识别神经内分泌来源的肿瘤和脑膜瘤；放射性示踪剂与生长抑素受体 2（SSTR2）结合，这种受体在这些恶性肿瘤中丰富表达。在这里，我们提出了一个罕见的病例，提示通过[Ga]Ga-DOTA-TATE PET 扫描检测到新的缺血性中风。该扫描是在切除非典型脑膜瘤 14 天后进行的，目的是评估残余肿瘤的范围，以便对手术腔进行放射外科治疗。令人惊讶的是，[Ga]Ga-DOTA-TATE PET 阳性区域与 MRI 检测到的围手术期亚急性缺血性中风区域相对应。该病例证实了之前报道的两例在常规[Ga]Ga-DOTA-TATE PET 成像中偶然检测到缺血性中风的病例，这共同表明在解释成像结果时需要谨慎。巨噬细胞募集到梗死组织中导致 SSTR2 表达增加，这可能是[Ga]Ga-DOTA-TATE 在中风中摄取的潜在机制。
