National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Between 10% and 15% of patients with endogenous hypercortisolism (Cushing syndrome) have ectopic (non-pituitary) production of adrenocorticotropin hormone (ACTH) that causes cortisol excess. In approximately 50% of these patients, the tumoral source of ACTH cannot be found initially despite very detailed and extensive imaging, including studies such as computed tomography, magnetic resonance imaging, and octreotide scan (Octreoscan) using the standard dose of indium- 111 pentetreotide (\[111In-DTPA-D-Phe\]-pentetreotide). The sensitivity and specificity of structurally based imaging studies depends on anatomic alterations and the size of the tumor. In contrast, positron emission tomography (PET) and somatostatin ligand imaging detect pathologic tissue based on physiologic and biochemical processes within the abnormal tissue. This protocol tests the ability of \[18F\]-L-3,4-dihydroxyphenylalanine (18F-DOPA) PET, and the somatostatin imaging analogue, 68Ga-DOTATATE-PET, to localize the source of ectopic ACTH production.
Study Description: Between 10% and 15% of patients with endogenous hypercortisolism (Cushing syndrome) have ectopic (non-pituitary) production of adrenocorticotropin hormone (ACTH) that causes cortisol excess. In approximately 50% of these patients, the tumoral source of ACTH cannot be found initially despite very detailed and extensive imaging, including studies such as computed tomography, magnetic resonance imaging, and octreotide scan (Octreoscan) using the standard dose of indium- 111 pentetreotide (\[111In-DTPA-D-Phe\]-pentetreotide). The sensitivity and specificity of structurally base…
* INCLUSION CRITERIA: To be eligible to participate in this study, an individual must meet all of the following criteria: * 18 - 90 years of age * Medical history of ectopic Cushing syndrome or diagnosed with the possibility of ectopic Cushing syndrome * For females of reproductive potential: agreement to use highly effective contraception for at least 2 weeks before any PET scan * Ability of subject to understand and the willingness to sign a written informed consent document * Stated willingness to comply with all study procedures and availability for the duration of the study EXCLUSION C…
68Ga-DOTATATE PET/CT
68Ga-DOTATATE PET/CT
routine CT scan
routine 1.5 or 3T MRI scan
Cardiac gated MRI scan
68Ga-DOTATATE radioligand
18F-DOPA radioligand
Arctuva estimate
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