Prevalence of Brain Incidental Lesions Detected by 68Ga-DOTA Peptides PET/CT

Background and Objectives: 68Ga-DOTA peptides positron emission tomography/computed tomography (PET/CT) is usually applied for the study of neuroendocrine tumours, but other tumours such as meningioma may also have an increased radiopharmaceutical uptake. The aim of this retrospective study was to establish the prevalence and the meaning of brain incidental uptake among patients who performed 68Ga-DOTA peptides PET/CT for other reasons. Materials and Methods: Overall, 510 68Ga-DOTA peptides PET/CT scans performed between January 2018 and February 2022 from 430 patients were reviewed for the analysis of incidental brain radiopharmaceutical uptake. All brain incidentalomas were compared with brain magnetic resonance imaging (MRI) and/or contrast-enhanced CT performed within an average time interval of ±60 days from PET/CT scan. Results: A total of 48 patients (14%) presented incidental focal intracranial radiotracer uptake. Thirty-eight (11%) of them had a suspected meningioma confirmed by MRI or contrast-enhanced CT imaging features. The remaining 10 had a final diagnosis different from meningioma (5 as brain metastases and 2 as venous anomalies) or were lost during the follow-up without performing MRI (n = 3). The average maximal standardized uptake value (SUVmax) of the suspected meningioma was 16.5 (range 5–33), and the average lesion to brain SUVmax ratio was 351 (range 80–550). Conclusions: Brain incidental uptake from the 68Ga-DOTA peptides PET/CT is not so rare, and meningioma is the most frequent cause.