Octreotide

Question 1

RP

Dose

Answer 1

111In DTPA
6 mCi
0.14 mCi/kg – Peds

Question 2

Indications

Answer 2

Evaluate neuroendocrine tumors
Evaluate serum calcitonin levels
Elevated gastrin levels

Question 3

Contraindications

Answer 3

Severe renal dysfunction

Question 4

Patient Prep

Answer 4

Hydrate well
Void before exam
Magnesium citrate prep (4 bottles)
Day of injection - Light breakfast and 1 bottle of mag citrate with clear liquids after injection. Light dinner and 2nd bottle of mag citrate.
Day 2 - Light lunch and dinner 1 bottle of mag citrate with clear liquids
Day 3 - Light meals and 1 bottle mag citrate with clear liquids

Question 5

Positioning

Answer 5

Supine arms at side

Question 6

Target Organ
Critical Organ
Method Localization
Route of Excretion

Answer 6

Target Organ – Neuroendocrine tumors
Critical Organ – Spleen, kidney, bladder
Method of Localization – chemical bonding to somatostatin receptors
Route of Excretion – 90% urinary, 10% bowel

Question 7

Procedure

Answer 7

Image at 4, 24, and 48 hours
4 hours - AP Whole body (head to knees); 8 cm/min
24 hours - SPECT - 20-30 sec stop, 64 stops; Another WB/ statics possible. Better target to background
48 hours possible

Question 8

Computer Set Up

Answer 8

MEGP
Tumor/Infection - Octreotide tomo/SPECT
WB – 8cm/sec
512x1024
Statics – 500,000 counts
512x512 or 256x256
SPECT - 20-30 sec/stop for 64 stops; 64x64

Question 9

Normal

Answer 9

Hepatic, renal, spleen, GB uptake
More bladder at 4 hours
More bowel at 24 hours

Question 10

Abnormal

Answer 10

Focal hot spots

Question 11

Treatment

Answer 11

Chemo therapy

Octreotide therapy