Schmorl Nodes Can Cause Increased 68Ga DOTATATE Activity on PET/CT, Mimicking Metastasis in Patients With Neuroendocrine Malignancy

Clin Nucl Med. 2016 Mar;41(3):249-50. doi: 10.1097/RLU.0000000000001065.

Abstract

Schmorl node (SN) is the herniation of the nucleus pulposus through the cartilaginous and bony endplate into the adjacent vertebral body. It is documented that SNs produce areas of moderately increased F-FDG uptake. We present a case of a patient with history of neuroendocrine tumor, who underwent Ga DOTATATE PET/CT for follow-up, showing increased focal vertebral uptake suggestive of bone metastasis. CT revealed typical findings of an SN. The presented case indicates that SNs should be considered when encountering focally increased skeletal uptake in Ga DOTATATE PET/CT studies, which can mimic metastasis in patients with history of neuroendocrine tumors.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Diagnosis, Differential
  • Humans
  • Intervertebral Disc Degeneration / diagnostic imaging*
  • Intervertebral Disc Displacement / diagnostic imaging*
  • Male
  • Multimodal Imaging
  • Neoplasm Metastasis
  • Neuroendocrine Tumors / diagnostic imaging*
  • Neuroendocrine Tumors / pathology
  • Organometallic Compounds
  • Positron-Emission Tomography*
  • Radiopharmaceuticals
  • Tomography, X-Ray Computed*

Substances

  • Organometallic Compounds
  • Radiopharmaceuticals
  • gallium Ga 68 dotatate

Supplementary concepts

  • Intervertebral disc disease