Clinical Presentation

A 70-year-old woman presents with mild diplopia and a lateral gaze. Twenty-eight years previously, she underwent resection of an olfactory esthesioneuroblastoma; two recurrences were also resected.

Fig. 97.1

Fig. 97.2

Fig. 97.3

• ¹¹¹In-pentetreotide

• If possible, withhold nonradiolabeled octreotide before the scan: withhold 24 hours for short- acting octreotide and 3 to 4 weeks for long-acting formulations.

• The patient should be well hydrated to enhance renal clearance.

• If the patient has an insulinoma, a glucose infusion should be available to treat paradoxical hypoglycemia.

• 6 mCi (222 MBq)

• Slow intravenous injection over 1 minute

• Medium-energy collimator

• 172- and 247-keV photopeaks, 20% window

• Planar: anterior and posterior views from head to pelvis at 4 and 24 hours

• SPECT: abdomen and pelvis at 4 hours

• SPECT: chest, abdomen, and pelvis at 24 hours

• Additional images can be obtained at 48 hours if there is uncertainty whether abdominal activity represents pathologic or physiologic uptake.

Image Interpretation