Exercise Testing in the Assessment of Chronic Congestive Heart Failure

1186 Aim: Neuroendocrine neoplasms (NENs) are relatively rare tumors originating from various neuroendocrine cells distributed throughout the body. Ga-68 DOTATATE is a recently FDA-approved radiopharmaceutical for the localization of somatostatin-receptor NEN. Although PET/CT is commonly used, PET/MRI is particularly well suited for NEN, as MRI provides superb soft tissue contrast and high spatial resolution, which allows for improved lesion detection such as abdominal/pelvic, meningeal and spinal lesions. In order to perform and accurately interpret DOTATATE PET/MRI, the nuclear medicine physician and nuclear radiologist need to have a thorough understanding of the imaging workflow, various imaging characteristics including physiologic, abnormal and artefactual findings, as well as the potential advantages and disadvantages compared to PET/CT. Learning Objectives: 1. To review the PET/MRI imaging workflow. 2. To review the physiologic uptake and potential pitfalls of DOTATATE PET with MRI correlation. 3. To review the PET/MRI characteristics and interpretation of NEN with and without Gd enhancement. 4. To discuss the advantage and disadvantage of PET/MRI compared to PET/CT. DOTATATE PET/MRI is being offered at our institution since March 2017 (mMR Biograph, Siemens). This Educational Exhibit, in a pictorial review format, aims to describe the PET/MRI workflow for NEN (torso scan vs. regional with/without Gd enhancement; MRI with/without DWI) and to review a wide range of imaging findings that cover physiologic and benign findings (e.g. arachnoid granulation, liver hemangioma, spinal osteoarthritis); various NEN locations (head/neck, chest, abdomen/pelvis); treatment monitoring; and post-treatment changes. The advantages of DOTATATE PET/MRI for the evaluation of NEN and the potential deficits related to MR imaging (e.g. lung lesion detection, attenuation correction problems) will also be illustrated.