False Positives on — DOTA PET Scans

The uncinate process is a small tongue of pancreatic tissue that curves behind the blood vessels supplying the small intestine. It is a normal part of the pancreas, not a separate organ. On DOTA PET it can show variable uptake because some normal pancreatic tissue carries somatostatin receptors, and this can look similar to a pancreatic neuroendocrine tumour on the PET images alone. The nuclear medicine physician will assess the precise location, shape and intensity of the finding against the CT and state in the report whether it is a normal variant or warrants further investigation.

Yes. Granulomatous and inflammatory conditions — including sarcoidosis, reactive lymph nodes and some thyroid conditions — can express somatostatin receptors and take up the tracer. This means uptake in a lymph node or an unusual location does not automatically mean a tumour deposit. Your clinical history is reviewed specifically for this reason. If you have a known inflammatory condition, tell your oncologist before the scan so the reporting team can factor it into their interpretation.

An accessory spleen — sometimes called a splenunculus — is a small piece of splenic tissue that sits outside the main spleen. They are a common anatomical variant found in a substantial proportion of the general population. On a DOTA PET they light up with the same high intensity as the main spleen, because they carry the same dense concentration of somatostatin receptors. This can make them look like a small tumour deposit, particularly in the upper abdomen. The reporting physician identifies them by checking whether the intensity and CT appearance match splenic tissue rather than a mass.

No. DOTA PET is regarded by ENETS, SNMMI and EANM as the most sensitive imaging approach currently available for neuroendocrine tumours. The existence of well-characterised false positive patterns — and the fact that experienced readers know how to resolve them by integrating the CT and clinical context — is evidence that the technique is well understood, not that it is unreliable. An ambiguous finding that is then clarified through additional information is the system working as designed.

Sometimes, yes. If the CT appearance and clinical history do not resolve the question, the report will recommend the next step. This might be a targeted MRI of the area, an endoscopic ultrasound if the pancreas is involved, or a repeat DOTA PET after a defined interval to see whether the finding changes over time. Which option is recommended depends on where the finding is, how clinically significant it is likely to be, and whether your situation requires an urgent answer or allows a period of monitoring.

DOTATATE and DOTANOC PET scans are coordinated through CION's partner imaging centres. At the time of writing, both are available at an indicative cost of ₹23,999 through these centres. Tracer availability is confirmed when you book — this matters if you are travelling from another city, as the tracer must be secured before you finalise your travel. Do not book travel until your CION team confirms the tracer is available on your chosen date. Your team will also advise which tracer applies to your specific situation.