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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

68Ga-DOTATOC PET/CT Uptake and Physiological Impairment in DIPNECH: An Exploratory Case Series

  1. 1Pneumonology Clinic, Athens Medical Center, 15125 Athens, Greece
  2. 2Second Pneumonology Department, School of Medicine, Athens University, Attikon University Hospital, 12461 Athens, Greece

Abstract

Background/Objectives: Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) can cause respiratory symptoms and physiological impairment. We explored whether quantitative somatostatin-receptor imaging by positron emission tomography/computed tomography with gallium-68-labelled DOTATOC (68Ga-DOTATOC PET/CT) is associated with pulmonary physiology and nodule count in histologically confirmed DIPNECH. Methods: This retrospective, single-centre, hypothesis-generating series included six consecutive adults diagnosed during 2020–2025. Spearman correlations with exact permutation p-values and 95% confidence intervals related the maximum standardised uptake value (SUVmax) of the most avid lesion to diffusing capacity for carbon monoxide (DLCO), forced expiratory flow between 25% and 75% of forced vital capacity (FEF25–75) and the ratio of forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC); index-lesion diameter and expected partial-volume recovery were examined. Analyses were exploratory and unadjusted for multiple comparisons. Results: All patients were women. SUVmax correlated inversely with DLCO (ρ = −0.90; p = 0.028) and FEF25–75 (ρ = −0.84; p = 0.044); the nodule-count–DLCO association was uncertain (ρ = −0.37; p = 0.50). Index lesions measured 3.6–4.7 mm, below the resolution of the PET system; lesion diameter was unrelated to SUVmax (ρ = −0.20), and the association with DLCO persisted after crude recovery correction (ρ = −0.66). Conclusions: Higher 68Ga-DOTATOC uptake of the most avid lesion accompanied greater physiological impairment in this six-patient series, and the differences in uptake were not explained by lesion size. Given the sample size, wide confidence intervals, multiple unadjusted comparisons, unadjusted comorbidities and sub-resolution lesions, these findings are hypothesis-generating only; they do not establish SUVmax as a marker of disease severity, an actionable threshold or a guide to biopsy, but support prospective investigation of somatostatin-receptor imaging in DIPNECH.

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BibTeX
@article{palamidas202668gadotatoc,
  title = {{68Ga-DOTATOC PET/CT Uptake and Physiological Impairment in DIPNECH: An Exploratory Case Series}},
  author = {Anastasios Palamidas and Vasilios Tzilas and Demosthenes Bouros},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15218316},
  url = {https://www.mdpi.com/2077-0383/15/21/8316},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - 68Ga-DOTATOC PET/CT Uptake and Physiological Impairment in DIPNECH: An Exploratory Case Series
AU  - Anastasios Palamidas
AU  - Vasilios Tzilas
AU  - Demosthenes Bouros
PY  - 2026
DA  - 2026/10/26
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218316
UR  - https://www.mdpi.com/2077-0383/15/21/8316
AB  - Background/Objectives: Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) can cause respiratory symptoms and physiological impairment. We explored whether quantitative somatostatin-receptor imaging by positron emission tomography/computed tomography with gallium-68-labelled DOTATOC (68Ga-DOTATOC PET/CT) is associated with pulmonary physiology and nodule count in histologically confirmed DIPNECH. Methods: This retrospective, single-centre, hypothesis-generating series included six consecutive adults diagnosed during 2020–2025. Spearman correlations with exact permutation p-values and 95% confidence intervals related the maximum standardised uptake value (SUVmax) of the most avid lesion to diffusing capacity for carbon monoxide (DLCO), forced expiratory flow between 25% and 75% of forced vital capacity (FEF25–75) and the ratio of forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC); index-lesion diameter and expected partial-volume recovery were examined. Analyses were exploratory and unadjusted for multiple comparisons. Results: All patients were women. SUVmax correlated inversely with DLCO (ρ = −0.90; p = 0.028) and FEF25–75 (ρ = −0.84; p = 0.044); the nodule-count–DLCO association was uncertain (ρ = −0.37; p = 0.50). Index lesions measured 3.6–4.7 mm, below the resolution of the PET system; lesion diameter was unrelated to SUVmax (ρ = −0.20), and the association with DLCO persisted after crude recovery correction (ρ = −0.66). Conclusions: Higher 68Ga-DOTATOC uptake of the most avid lesion accompanied greater physiological impairment in this six-patient series, and the differences in uptake were not explained by lesion size. Given the sample size, wide confidence intervals, multiple unadjusted comparisons, unadjusted comorbidities and sub-resolution lesions, these findings are hypothesis-generating only; they do not establish SUVmax as a marker of disease severity, an actionable threshold or a guide to biopsy, but support prospective investigation of somatostatin-receptor imaging in DIPNECH.
SN  - 2077-0383
ER  -