Do you obtain biopsies to confirm positive DOTATATE PET scans during surveillance or treatment?

The answer to this question all depends on the clinical scenario. Modern-day SSTR PET imaging (Ga68 DOTATATE, Ga68 DOTATOC, Cu64 DOTATATE) has both sensitivity and specificity over 90 percent for NETs (van de Berg et al., PMID 29025892). Thus, if you have uptake in, for example, the liver, a mesenteric node, or the bone, you can be quite confident that it is a recurrence. In those scenarios, I typically avoid a biopsy.

The caveats to the above are the following:

• There is the question of the diffe...