Journal of Diagnostics Concepts & Practice >

2026 , Vol. 25 >Issue 02: 193 - 199

DOI: https://doi.org/10.16150/j.1671-2870.2026.02.010

Original articles

Value of 68Ga-DOTATATE PET/CT in differentiating pancreatic neuroendocrine tumors from uncinate process of pancreas

  • LI Xiang ,
  • HUANG Xinyun ,
  • GUO Rui ,
  • LI Biao ,
  • ZHOU Yilei
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  • Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2025-06-24

  Revised date: 2025-08-14

  Accepted date: 2025-12-16

  Online published: 2026-04-25

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Abstract

Objective To observe the differences in 68Ga-DOTATATE uptake among pancreatic neuroendocrine tumor (NET), the tissues of the pancreatic uncinate process, and other pancreatic tumors in 68Ga-DOTATATE PET/CT images, and to analyze their diagnostic performance. Methods A retrospective study was conducted on 133 consecutively enrolled patients who underwent 68Ga-DOTATATE PET/CT between January 2020 and June 2022 for suspected NET (58 cases were pathologically diagnosed with pancreatic NET, 12 cases with other pancreatic tumors, and 63 cases were confirmed as having non-pancreatic tumors during follow-up). Clinical data were retrospectively analyzed, and a total of 158 target regions with high 68Ga-DOTATATE uptake were obtained and divided into three groups: physiological uptake in the pancreatic uncinate process, pancreatic NET, and other pancreatic tumors. Differences in maximum and mean standardized uptake values (SUVmax and SUVmean) among these groups were compared. The ratios of uptake in the target region to the spleen (SUVmax-T/SUVmax-S, SUVmean-T/SUVmean-S) or the liver (SUVmax-T/SUVmax-L, SUVmean-T/SUVmean-L) were calculated. The receiver opera-ting characteristic (ROC) curve analysis was used to assess the diagnostic ability of different parameters for various pancreatic lesions. Results 68Ga-DOTATATE uptake in pancreatic NET was significantly higher than those in the physiological uptake in the uncinate process and other pancreatic tumors (SUVmax values were 54.87±35.77, 27.70±51.55, and 8.94±3.04, respectively, all P<0.05; SUVmean values were 32.76±23.04, 14.79±28.15, and 6.28±2.11, respectively, all P<0.05). The uptake of 68Ga-DOTATATE in other pancreatic tumors was higher than that in the uncinate process, and except for SUVmax, there were no statistically significant differences in other parameters between the two groups (P>0.05). The SUVmax-T/SUVmax-S ratio accurately differentiated pancreatic NET from non-pancreatic NET (other pancreatic tumors or physiological uptake in the pancreatic uncinate process), with an AUC of 0.929, a sensitivity of 0.855, a specificity of 0.948, and an optimal cutoff value greater than 0.802. Conclusions Physiological uptake can be observed in the pancreatic uncinate process on 68Ga-DOTATATE PET/CT. Parameters related to the SUVmax-T/SUVmax-S and SUVmean-T/SUVmean-S ratios can accurately distinguish pancreatic NET from the physiological uptake in the pancreatic uncinate process and other pancreatic tumors.

Key words： Neuroendocrine tumors; Pancreatic uncinate process; 68Ga-DOTATATE; PET/CT; Receiver operating characteristic

Cite this article

LI Xiang , HUANG Xinyun , GUO Rui , LI Biao , ZHOU Yilei . Value of 68Ga-DOTATATE PET/CT in differentiating pancreatic neuroendocrine tumors from uncinate process of pancreas[J]. Journal of Diagnostics Concepts & Practice, 2026 , 25(02) : 193 -199 . DOI: 10.16150/j.1671-2870.2026.02.010

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