THE LACNETS PODCAST
Episode 7: Imaging of NETs
ABOUT THIS EPISODE:
Confused about scans? NET expert Dr. Gary Ulaner answers the top 10 questions about imaging for NETs. Dual board-certified in radiology and nuclear medicine, Dr. Ulaner explains different scans used in NET imaging including functional imaging scans such as Gallium-68 DOTATATE, Copper-64 DOTATATE, and FDG PET scans and anatomical scans such as MRI and CT scans. He addresses common questions about radiation safety, contrasts, and SUV.
MEET DR. GARY ULANER
Gary A. Ulaner, M.D., Ph.D., F.A.C.N.M. is the Director of Molecular Imaging and Therapy at Hoag Family Cancer Institute.
Dr. Ulaner was previously with Memorial Sloan Kettering Cancer Center, where he served as the PET/CT expert on the Breast Cancer Disease Management Team. Dual board-certified in radiology and nuclear medicine, Dr. Ulaner is a nationally recognized expert in the use of targeted imaging to help direct focused cancer therapies. He leads several National Institutes of Health (NIH) clinical trials in molecular imaging and therapeutics, including two active NIH R01 grants, and has received more than $8 million in extramural funding.
Dr. Ulaner has received multiple honors throughout his career. He was elected Fellow of the American College of Nuclear Medicine, received an award for breast cancer research from the Susan Komen Foundation, and was the first Hal O’Brien Rising Star from the Society of Nuclear Medicine and Molecular Imaging (SNMMI), among other accolades.
Dr. Ulaner has authored or co-authored more than 110 peer-reviewed manuscripts and has given more than 110 clinical presentations, both nationwide and internationally, in addition to writing the textbook Fundamentals of Oncologic PET/CT, published in both English and Spanish. He is also on the editorial boards of several leading clinical journals including: Radiology, Journal of Nuclear Medicine, European Journal of Nuclear Medicine and Molecular Imaging, and Clinical Nuclear Medicine.
Dr. Ulaner completed his medical degree and a Ph.D. in Cancer Biology at Stanford University School of Medicine, an internship at Johns Hopkins Hospital, and his Radiology and Nuclear Medicine residencies at the University of Southern California.
TOP 10 IMAGING QUESTIONS
1. What is the difference between a DOTATATE PET/CT scan and a FDG PET scan, or the type of PET scans that are commonly ordered for other types of cancers?
2. What is the difference between the Gallium-68 DOTATATE and the newer Copper-64 DOTATATE scans? What are the benefits of one over the other? Should I be getting a Copper-64 scan?
3. I’ve been hearing more about DOTATOC in the US where in the past I've only heard it from European specialists. What is it and are there advantages to DOTATOC vs. DOTATATE?
4. What do SUV values mean on DOTATATE PET Scans?
5. What is the difference between the CT scan in the DOTATATE PET/CT scan and a “regular” CT scan?
6. What type of CT scan should be done to evaluate NET? Should a CT scan be done with contrast? If so, what type of contrast?
7. What is the difference between MRI and CT scan? What type of MRI scan should be done to evaluate NET? Should a MRI scan be done with contrast? If so, what type of contrast? Regarding eovist - the contrast agent of choice, are all the gadolinium agents equal?
8. How concerned should patients be about radiation safety with CT scans, MRI scans, DOTATATE scans, and PRRT?
9. What do you suggest for those of us whose tumors don’t show up on scans? What scan(s) do you do if someone does not have uptake on Ga68 dotatate? What about those whose tumors don’t show up on any scans?
10. What suggestions do you have for patients who are trying to understand their scan report?