An octreotide scan, also called somatostatin receptor scintigraphy, uses a radioactive tracer that binds specifically to somatostatin receptors on the surface of certain cells. Many neuroendocrine tumours (NETs) display these receptors in large numbers, which makes them light up brightly on the scan — sometimes even when they are too small to be seen on CT or MRI.
Newer PET-based versions of the same idea — Ga-68 DOTATATE or DOTATOC PET/CT — are now the preferred test where available because they are more sensitive and use lower radiation, but conventional octreotide scans remain widely used in centres that do not yet offer DOTATATE PET.
Common Indications for an Octreotide Scan
Your doctor may request an octreotide scan to:
- Locate a suspected neuroendocrine tumour in someone with characteristic symptoms or hormone elevations.
- Stage a known neuroendocrine tumour and find unsuspected metastases.
- Decide whether a tumour is likely to respond to somatostatin-analogue treatment (octreotide / lanreotide) or peptide receptor radionuclide therapy (PRRT).
- Follow up a treated neuroendocrine tumour to look for recurrence.
- Evaluate certain other tumours that express somatostatin receptors — paragangliomas, phaeochromocytomas, medullary thyroid cancer, some lymphomas.
What exactly does the scan show?
Wherever the tracer accumulates above background, the scan suggests cells expressing somatostatin receptors. Most often this means:
- A neuroendocrine tumour — primary tumour, lymph nodes, liver metastases, bone metastases.
- Normal tissues that express receptors — pituitary gland, thyroid, spleen, kidneys, bladder. These are recognised by the reading physician and not mistaken for disease.
- Inflammation — occasionally, areas of active inflammation can also take up tracer; clinical context is used to interpret these.
A negative scan in a setting where neuroendocrine disease is strongly suspected does not entirely rule out disease — some neuroendocrine tumours, particularly higher-grade ones, lose their somatostatin receptors and become difficult to see on this test.
What happens during the procedure?
A conventional octreotide scan is performed over two days:
Day 1 (injection day):
- A small needle is placed in a vein in your arm.
- The radioactive tracer (typically Indium-111 pentetreotide) is injected.
- You can usually go home and continue normal activities while the tracer distributes.
- Initial images may be taken at 4 hours.
Day 2 (imaging day):
- You return 18 to 24 hours after the injection.
- The gamma camera takes whole-body images, sometimes with additional SPECT or SPECT/CT images of specific areas.
- Total imaging time is usually 1 to 2 hours.
Some centres add a Day 3 imaging session for delayed views if needed.
A DOTATATE PET/CT version, when available, is done in a single 2 to 3 hour visit and is generally faster and more sensitive.
Do I need to prepare?
- You may need to stop somatostatin-analogue medications (octreotide, lanreotide) before the scan — short-acting forms typically for 24 hours, long-acting forms for 4 to 8 weeks. These medications occupy the same receptors as the tracer and can reduce sensitivity. Never stop these medications without explicit instructions from your treating doctor.
- Hydrate well in the 24 hours before each visit.
- No fasting is required.
- Bring previous imaging (CT, MRI, prior nuclear scans).
- Tell the team if there is any chance of pregnancy.
- Tell the team if you are breastfeeding — you will need to pump and discard milk for a period after the injection.
Will the test be painful?
The scan itself is painless. The only physical discomfort is the needle prick for the tracer injection. The gamma camera moves over you while you lie still on the imaging table — many patients find the longer scans tedious but not uncomfortable.
How long do the results take?
A nuclear medicine physician usually reads the study within 1 to 2 working days. The formal report typically reaches your doctor within 3 to 5 working days. Urgent cases can be expedited.
What about the radiation dose?
Radiation dose context
A conventional octreotide scan delivers a radiation dose roughly equivalent to several years of natural background radiation — higher than a standard nuclear medicine bone scan because of the two-day protocol and SPECT/CT components. A DOTATATE PET/CT typically delivers a similar or slightly lower dose with substantially more diagnostic information.
For most patients being scanned for neuroendocrine tumour evaluation, the diagnostic benefit far outweighs the dose, but the radiation matters when planning repeated scans over years.
What happens after a positive scan?
If the scan shows somatostatin-receptor-positive disease:
- The location and extent of disease guide treatment.
- Many patients with positive scans benefit from somatostatin-analogue therapy (octreotide LAR or lanreotide injections) to control symptoms and slow growth.
- Patients with widespread receptor-positive disease may be candidates for peptide receptor radionuclide therapy (PRRT) using Lu-177 DOTATATE — a treatment that delivers therapeutic radiation directly to receptor-expressing tumour cells.
- Surgery, ablation, or chemotherapy may still be considered depending on the overall picture.
What about food restrictions or contrast?
Octreotide scans do not require iodine contrast and do not need fasting. You can eat and drink normally before and during the imaging visits.
Conclusion
An octreotide scan is the established whole-body imaging test for neuroendocrine tumours, capable of finding receptor-positive disease that is invisible on routine CT or MRI. The two-day protocol is longer than most nuclear medicine tests, but the diagnostic information is uniquely valuable for staging, treatment selection, and follow-up. Where available, DOTATATE PET/CT is the more sensitive modern equivalent and is increasingly the first-line test.