Methods:
Three patients were diagnosed with Neuroblastoma since the beginning of
the COVID 19 pandemic in March 2020.
MIBG scintigraphy had to be cancelled for patient 1 due to
radiopharmaceutical not arriving on the scheduled date as a result of
the cancellation of flights. In discussion with the clinical team, we
decided to carry out 68Ga-DOTATATE PET/CT imaging as
an alternative. For both the subsequent patients,68Ga- DOTATATE PET/CT was done electively to avoid
delay and hazard during the pandemic.
A 68Germanium/68Gallium generator
was used to produce 68Ga locally, which was
radiolabeled with DOTATATE. Required quality control tests were
performed prior to injecting the patient in accordance with good
manufacturing practices (GMP). Following radiopharmaceutical injection
an uptake phase of 45-60 minutes took place prior to scanning the
patient. All 3 patients were scanned on a GE Discovery 690 PET-CT
scanner with an axial field of view of 15.7 cm. A low dose CT scan (80
kVP, mA dose modulation, ASIR, 0.5 s rotation time, 40-mm collimation),
was performed for attenuation correction and anatomical localization
followed by a whole body PET at 4 min per bed acquisition with an 11
slice overlap. All data corrections for scatter, randoms and attenuation
were employed as implemented on the scanner front end. Images were
reconstructed with time of flight iterative reconstruction algorithm
with a correction for point spread function (VPFX - 2 iterations, 28
subsets), and a 3.4 mm post reconstruction Gaussian filter. The final
pixel sizes were 1.56 x 1.56 mm with a slice thickness of 3.27 mm. All 3
patients were scanned under general anesthesia (GA). The need for
sedation was independent of the type of study, as they would have
required GA for MIBG as well. There were no complications.