Compressed Pineal Gland by Cavum Velum Interpositum Cyst on 68Ga-DOTATATE PET/CT: A Potential Pitfall in Interpretation.

A 6-year-old boy with high-risk neuroblastoma underwent 123I-MIBG SPECT/CT, which did not reveal any abnormal 123I-MIBG accumulation. Subsequently, 68Ga-DOTATATE PET/CT demonstrated focal abnormal 68Ga-DOTATATE accumulation in the left ventricle, with no other abnormal radiotracer uptake noted elsewhere. Brain MRI revealed a cavum velum interpositum cyst compressing the pineal gland. The distribution 68Ga-DOTATATE within the compressed pineal gland on follow-up PET/CT was consistent with initial 68Ga-DOTATATE PET/CT findings. On the basis of this case, increased 68Ga-DOTATATE uptake within the compressed pineal gland represents a potential diagnostic pitfall in 68Ga-DOTATATE PET/CT imaging.