Somatostatin receptor positron emission tomography/computed tomography (PET/CT) in the evaluation of opsoclonus-myoclonus ataxia syndrome
A two year old male child presented with acute onset of ataxia. His parents reported involuntary eye movements in child of two weeks duration. There was no history of fever and other systemic complaints. On clinical examination, he was found to have OMA syndrome. His previous investigation included chest X-ray, urinary vanillylmandelic acid (VMA) measurement, brain MRI and CSF examination, which did not reveal any abnormality. With suspicion of underlying neuroblastoma, SSR PET/CT with 68Gallium DOTATATE was performed. 1.5 mCi of 68Gallium-DOTATATE was injected intravenously to the patient. After 1 hr of injection, patient was scanned on dedicated 16 slice PET /CT. Whole body diagnostic CT scan was obtained as part of PET/ CT protocol on Multislice CT with 3.5 mm slice thickness.\nThe scan demonstrated increased tracer uptake in left paravertebral region at the level of T3-T5 vertebrae [Arrow in ]. Maximum standardized uptake value SUVmax of the lesion was 10.1. On CT and fused PET/CT images the uptake localized to a soft tissue density lesion with specks of calcification within [Figure and , arrows]. Physiological tracer distribution was noted in the spleen, kidneys and urinary bladder. The paravertebral lesion was suggestive of NB. Surgical resection of lesion confirmed diagnosis of NB. Post surgery and short course of steroids, OMA resolved. At present, one year after the initial presentation; this child has no evidence of disease.