When should a gallium-dotatate scan be incorporated into the initial evaluation of a patient with a carcinoid tumor of the appendix?

Good question! I would first refer the reader to my two favorite papers on appendiceal NETs (Rault-Petit et al., PMID 29557879; Landry et al., PMID 18645109) to understand and help determine: 1) which patients are at highest risk of lymph node metastasis and thus require a right hemicolectomy, and 2) which patients are at highest risk of recurrence. There are currently 5 guidelines outlining management for appendiceal NETs making this determination quite nuanced.

Patients with tumors > 2 cm have the highest risk of lymph node mets and thus those patients should have a right hemicolectomy. Patients in the < 1 cm and 1-2 cm range require more scrutiny (see above reference by Rault-Petit B, et al) to help determine if right hemicolectomy. If pa...