Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2014 Sep;13(3):201-4.
doi: 10.4103/1450-1147.144823.

Gallium-68 DOTA-TATE Positron Emission Tomography/Computed Tomography: Scintigraphic Changes of Adrenal Glands Following Management of Ectopic Cushing's Syndrome by Steroidogenesis Inhibitors

Yu-Ting Huang  1 , Shaikh Irfan Aziz  2 , Aravind S Ravi Kumar  3
Affiliations
Case Reports

Gallium-68 DOTA-TATE Positron Emission Tomography/Computed Tomography: Scintigraphic Changes of Adrenal Glands Following Management of Ectopic Cushing's Syndrome by Steroidogenesis Inhibitors

Yu-Ting Huang et al. World J Nucl Med. 2014 Sep.

Abstract

In the era of emerging functional imaging techniques, an understanding of the effects of hormonal therapies on the scintigraphic appearance of endocrine organs is desirable to minimize the erroneous scan interpretation. The mechanisms by which changes in the scintigraphic appearance of endocrine organs occur however sometimes remain ambiguous. This case demonstrates the gallium-68 (Ga-68) DOTA-TATE positron emission tomography/computed tomography (CT) appearance of adrenal glands following management with steroidogenesis inhibitors. The potential mechanisms underlying this change are discussed. A 17-year-old boy with adrenocorticotropic hormone (ACTH) dependent Cushing's syndrome secondary to ectopic ACTH secretion underwent pre- and post-metyrapone and dexamethasone treatment Ga-68 DOTA-TATE scans 4 months apart. Pretreatment, both adrenals demonstrated normal symmetrical prominent Ga-68 DOTA-TATE uptake and normal CT appearance. The posttherapy scan revealed marked symmetrical suppression of Ga-68 DOTA-TATE uptake, but with bilateral adrenal hypertrophy on CT.

Keywords: Adrenal suppression; cushing's syndrome; gallium-68 DOTA-TATE positron emission tomography/computed tomography; metyrapone; steroidogenesis inhibitor.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Gallium-68 DOTA-TATE positron emission tomography/ computed tomography scans pre-and post-metyrapone treatment showing marked adrenal suppression posttreatment
Figure 2
Figure 2
Pre- and post-treatment axial CT showing enlarging adrenal glands post treatment
Figure 3
Figure 3
Action of metyrapone therapy on the steroidogenesis pathway
See this image and copyright information in PMC

References

    1. More J, Young J, Reznik Y, Raverot G, Borson-Chazot F, Rohmer V, et al. Ectopic ACTH syndrome in children and adolescents. J Clin Endocrinol Metab. 2011;96:1213–22. - PubMed
    1. Savage MO, Chan LF, Grossman AB, Storr HL. Work-up and management of paediatric Cushing's syndrome. Curr Opin Endocrinol Diabetes Obes. 2008;15:346–51. - PubMed
    1. Carroll T, Aron DC, Findling JW, Tyrrell JB. Glucocorticoids and adrenal androgens. In: Gardner DG, Shoback D, editors. Greenspan's Basic and Clinical Endocrinology. 8th ed. San Francisco: McGraw-Hill; 2007. p. 378.
    1. Shastry M, Kayani I, Wild D, Caplin M, Visvikis D, Gacinovic S, et al. Distribution pattern of 68Ga-DOTATATE in disease-free patients. Nucl Med Commun. 2010;31:1025–32. - PubMed
    1. Willhauck MJ, Pöpperl G, Rachinger W, Giese A, Auernhammer CJ, Spitzweg C. An unusual case of ectopic ACTH syndrome. Exp Clin Endocrinol Diabetes. 2012;120:63–7. - PubMed

Publication types