DOTANOC
A gallium-68 octreotide tracer that maps neuroendocrine tumours by their somatostatin receptors
DOTANOC is a modified octreotide peptide that carries radioactive gallium-68 to somatostatin receptors, which neuroendocrine tumours display in large numbers, so a PET scan can show where the tumours are. It is widely used in published studies from Europe and Asia but holds no FDA or EMA approval. It is a hospital diagnostic, not a product anyone can buy.
Used in human trials: About 185 MBq, Single injection, Intravenous (Study: biodistribution and dosimetry, 9 patients) Details ↓
Recommended Dosing
Used in human trials
No manufacturer dose exists for this use: these are amounts given in published trials, not recommendations.
What is it?
Some tumours can be found by what they wear on their surface. Neuroendocrine tumours, which grow from hormone-making cells in the gut, pancreas, lungs and elsewhere, usually carry many receptors for somatostatin, a natural hormone. A radioligand scan exploits that: a small amount of a somatostatin-like peptide carrying a radioactive atom is injected, it sticks to the receptors, and a PET scanner shows where it has collected. The pictures help find a primary tumour, count its spread and decide whether a patient can receive the matching radioactive treatment, such as lutetium-177 dotatate.
DOTANOC is one of three closely related gallium-68 tracers built on octreotide, the long-acting somatostatin drug. All three carry a DOTA ring that holds the gallium; they differ by one or two amino acids. DOTANOC has 1-naphthylalanine at position 3, which gives it affinity for somatostatin receptor subtypes 2, 3 and 5, while dotatate is selective for subtype 2. Its siblings have their own entries: gallium-68 dotatate (NETSPOT) and copper-64 dotatate (Detectnet), approved in the US, and edotreotide (DOTATOC), authorised EU-wide as SomaKit TOC.
DOTANOC itself has no approval from FDA or the European Medicines Agency, and our searches of the EMA register and of national medicines information found no marketing authorisation under this name (October 29, 2026). The studies below describe it being labelled in the hospital with an automated synthesis unit before each scan. It is a radioactive diagnostic made and given only by nuclear medicine teams, and there is nothing a person could buy or use outside that setting.
How well does it work? A French multicentre study of 105 patients with grade 1 or 2 gut and pancreatic tumours found it more sensitive than conventional imaging (98.9% against 88.6% of patients), especially for spread to the lining of the abdomen and to bone, and it changed treatment in 42%. An Italian centre that ran more than 2,000 scans over five years found a positive scan in about 73%. Against its siblings the results point both ways: in a small randomised crossover trial it found more lesions than dotatate (93.5% against 85.5%), largely liver metastases, while a Turkish comparison found dotatate gave higher tumour uptake and DOTANOC missed 14 of 130 lesions. A 2025 review concluded the three tracers can largely be used interchangeably.
It has been tried well beyond gut tumours. In 106 patients with phaeochromocytoma or paraganglioma it found more lesions than the older MIBG scan; in lung carcinoids it gave useful new information in about a third of patients; and it has been studied for hidden tumours that secrete ACTH, thyroid cancer that no longer takes up iodine, and, because inflamed tissue also carries somatostatin receptors, cardiac sarcoidosis. That same breadth is its main pitfall: a 2026 review of 76 studies collected 799 uptake sites that were not the tumour being looked for; nearly 60% had causes other than cancer.
Newer agents have moved past it in some head-to-head studies. Fluorine-18 DOPA found more lesions in midgut tumours, and a somatostatin receptor antagonist tracer detected 94% of lesions against 83% for DOTANOC. In dosimetry work, about 185 MBq gave an effective dose of 0.025 mSv per MBq, about 4.6 mSv, with the kidneys receiving the most, and normal uptake differs a little between men and women and with diabetes.
Mechanism of Action
DOTANOC carries gallium-68 to somatostatin receptors, so receptor-rich neuroendocrine tumours show on a PET scan.
Somatostatin receptor binding
The octreotide core with 1-naphthylalanine binds receptor subtypes 2, 3 and 5.
Positron imaging
The DOTA ring holds gallium-68, whose positrons the PET scanner detects.
Distribution and clearance
Normal uptake in pituitary, spleen, liver and kidneys; excretion is mainly in urine, so kidneys and bladder wall receive the most radiation.
Published Research
The studies behind DOTANOC, read from their PubMed abstracts. All used the gallium-68 tracer in people; studies of DOTANOC labelled with therapeutic isotopes are not included.
Prospective multicentre study in grade 1-2 GEP-NET
In 105 patients, sensitivity was 98.9% per patient against 88.6% for conventional imaging (somatostatin scintigraphy, CT and MRI), with large gains for peritoneal (95% against 30%) and bone (100% against 33.3%) disease; management changed in 41.9%.
Five years at an ENETS centre
An Italian archive of 2,082 scans in 1,537 patients with confirmed or suspected neuroendocrine tumours recorded a detection rate of 73.2%, higher for staging, therapy selection and response assessment.
Randomised crossover against dotatate
In 18 patients with gut and pancreatic neuroendocrine tumours, lesion-based sensitivity was 93.5% with DOTANOC against 85.5% with dotatate, mainly through more liver metastases; DOTANOC changed treatment in 3 of 18.
Same patients, dotatate higher uptake
In 20 patients scanned with both, the tracers agreed on which patients were positive and gave comparable accuracy, but lesion uptake was higher with dotatate and 14 of 130 lesions showed no DOTANOC uptake.
Review: dotatate, DOTANOC and DOTATOC
A narrative review judged DOTANOC's broader receptor profile of little advantage in gut and pancreatic tumours, where subtype 3 is scarce, noted its lower tumour-to-background ratio, and concluded the three tracers can largely be used interchangeably.
Against fluorine-18 DOPA in midgut tumours
In 30 patients given 150 MBq of DOTANOC and 210 MBq of fluorine-18 DOPA, DOPA detected more lesions (95.5% against 88.2%) and more involved regions.
Against an antagonist tracer
In patients with well-differentiated gut and pancreatic tumours, lesion sensitivity was 94.3% for the antagonist [68Ga]Ga-DATA5m-LM4 against 83.5% for DOTANOC, with the antagonist better for liver and bone; the antagonist is investigational.
Phaeochromocytoma and paraganglioma
In 106 patients with known or suspected disease, DOTANOC PET/CT found more than 79 lesions in 55 patients against 41 lesions in 34 with MIBG scintigraphy; the authors proposed it as a first-line test.
Lung carcinoids at two ENETS centres
Across 47 scans in 46 patients, DOTANOC gave additional information in 37% and changed management in 26%, finding occult metastases in 21%, including distant spread in 3 of 19 after surgery.
Hidden tumours that secrete ACTH
In 12 patients with ectopic ACTH syndrome, DOTANOC PET/CT found 9 of 13 culprit lesions (69.2%) with no false positives, while contrast CT found 12 of 13 but with five false positives.
Thyroid cancer with a negative iodine scan
In 62 patients with rising thyroglobulin, DOTANOC was positive in 65% against 72% with FDG; it saw fewer lesions (65% against 90.3%) but changed management in 34%.
Cardiac sarcoidosis
In 23 patients, DOTANOC PET/CT agreed closely with cardiac MRI segment by segment (kappa 0.88) and gave lesion uptake similar to FDG PET, without FDG's dietary preparation.
Uptake as a prognostic sign
In 47 patients followed after the scan, a maximum SUV of 19.3 or more, a well-differentiated tumour and combined somatostatin analogue treatment predicted a better course.
Uptake that is not the tumour
A systematic review of 76 studies and 542 patients collected 799 non-target uptake sites: 59.6% non-cancerous, 30.2% other malignancies and 10.3% benign tumours, most often in the abdomen.
Normal organ uptake in 89 patients
Uptake was highest in the spleen and kidneys and varied widely in the spleen; the uncinate process of the pancreas showed physiological uptake that has to be told apart from tumour.
Sex, age and diabetes change normal uptake
In 118 scans, women had lower uptake than men in stomach, liver and adrenal glands, and diabetes and age under 50 raised stomach uptake; proton pump inhibitors had little effect.
Biodistribution and dosimetry
Nine patients received about 185 MBq; the kidneys had the highest absorbed dose (0.09 mSv per MBq), excretion was mainly urinary, and the mean effective dose was 0.025 mSv per MBq.
Dosing Data
DOTANOC has no approved label. These are activities given in published human studies, each a single injection before a PET scan.
Educational information, not medical advice. Each dose above is tagged with its source: an approved label, a published human study, animal data, or amounts reported by users. None is a recommendation for you. An unapproved compound has no established safe or effective human dose, and products sold for “research use only” are not made or tested for people. Talk to a doctor before acting on anything on this site, including before you start, stop or change any medicine or dose. Full medical disclaimer.
What a Buyer Needs to Know
What is sold, how it is mixed, stored and taken, and what is known about its safety, quality and legal status. Each part names its source. Where we have none, it says unknown.
What is sold
Unknown: we hold no regulator's label that says in what form DOTANOC is supplied. It is a radioactive drug: the next part says where it is prepared and given.
Mixing a vial: a worked example
Nothing to mix at home, and no syringe units to work out: DOTANOC is a radioactive drug, prepared and given in nuclear-medicine departments, and its dose is an amount of radioactivity (MBq or GBq), not a weight.
This page's dosing note: “DOTANOC is dosed by radioactivity and labelled in a hospital radiopharmacy shortly before the scan; no reconstitution maths applies.”
Source: this page's own note in Dosing Data below; the amount of each dose row in Dosing Data below.
Storage before and after mixing
Unknown: no label on file says how DOTANOC is stored. It is a radioactive drug held by the nuclear-medicine department that prepares and gives it (see the part above); the home rules for a mixed vial in the mixing guide do not apply to it.
How it is taken
As it was given in human studies: Intravenous (Single injection; Study: biodistribution and dosimetry, 9 patients).
Source: Used in human trials: the route and frequency of each row in Dosing Data below.
What to expect, and when
How long it stays in the body: not established by a measurement cited on this entry.
How long the doses were given: Study: biodistribution and dosimetry, 9 patients: Scans from 5 to 120 minutes after injection; Study: midgut neuroendocrine tumours, 30 patients: One PET/CT.
When effects appear: unknown; no source on this page gives a time to effect for DOTANOC. Results reported in the studies are under Published Research.
Source: Used in human trials, the duration of each row in Dosing Data below.
Side effects, and when to stop or get help
From the Side Effects section: Radiation exposure: an effective dose of 0.025 mSv per MBq, with the kidneys and bladder wall receiving the most; Non-target uptake from inflammation and benign lesions, which can be mistaken for tumour. Full list and cautions ↓
When to stop or get help: unknown; no label or trial on file sets rules for stopping DOTANOC. Treat a severe or unexpected reaction as a reason to stop and see a doctor.
Source: the Side Effects section below (“From the studies above”).
Interactions
Unknown: a PubMed search for human interaction studies of DOTANOC (reviewed 2026-10-28) found none. Unknown is not the same as safe to combine.
Every peptide's record, with its source: the interaction matrix.
Checking what you bought
Unknown: no published independent test of DOTANOC products is in our lab-results database yet, so how products sold under this name measure up is not known.
To read a certificate of analysis, paste it into the COA decoder; it checks the measured mass against DOTANOC's expected mass, 1,455.7 Da, from this entry's molecular data. Trust & Verification explains what independent testing can and cannot show.
Legal status
US: In Clinical Trials (Not approved by FDA or EMA: Drugs@FDA and the EMA medicines list hold no record, and no national marketing authorisation was found (searched October 29, 2026)). Sport: Prohibited (S0 catch-all).
Country by country ↓ · Regulatory tracker
Source: this entry's approval status and the WADA Prohibited List, as in Legal Status below.
Side Effects & Contraindications
Reported Side Effects
From the studies above. None of the abstracts read reported adverse reactions to the tracer.
Contraindications & Cautions
No approved label exists, so there are no official contraindications. Points from the studies above:
Legal Status
DOTANOC is not approved by FDA or the EMA; published centres label it on site for PET.
Frequently Asked Questions
?What is a somatostatin receptor scan?
A PET scan after an injection of a somatostatin-like peptide carrying a radioactive atom. Neuroendocrine tumours carry many somatostatin receptors, so the scan shows where they are.
?Is DOTANOC approved?
No. FDA and the EMA have not approved it, and no national authorisation was found. The approved alternatives are gallium-68 dotatate and copper-64 dotatate in the US and edotreotide (SomaKit TOC) in the EU.
?Can I buy it?
No. It is a radioactive diagnostic labelled in a hospital radiopharmacy shortly before the scan and given by nuclear medicine staff. It has no use outside imaging.
?How does it differ from dotatate?
It binds somatostatin receptor subtypes 2, 3 and 5, while dotatate prefers subtype 2. Studies disagree on which finds more lesions, and a 2025 review treated them as broadly interchangeable.
?What can confuse the scan?
Inflammation, some benign lesions and normal tissue such as the spleen, adrenals and part of the pancreas also take it up, so findings are read with the clinical picture.
References
- [other] PubChem CID 15518147 (synonyms DOTA-NOC, DOTA-nal3-octreotide): formula C69H94N14O17S2, molecular weight 1455.7; IUPAC name a cyclic (2-7) disulfide octreotide analogue with 3-(1-naphthyl)-L-alanine. Read October 28, 2026. https://pubchem.ncbi.nlm.nih.gov/compound/15518147
- [registry] ClinicalTrials.gov API v2, read October 28, 2026: NCT01747096 (gastroenteropancreatic neuroendocrine tumours, completed); NCT01321996 (phase 4, idiopathic pulmonary fibrosis, terminated).
- [other] European Medicines Agency, medicines list (downloaded October 3, 2026; searched October 29, 2026): no record for DOTANOC. No Drugs@FDA record (openFDA, searched October 29, 2026).
- [pubmed] Lugat A, et al. "Prospective Multicentric Assessment of (68)Ga-DOTANOC PET/CT in Grade 1-2 GEP-NET." Cancers (Basel), 2023;15(2). PMID: 36672462.
- [pubmed] Bonazzi N, et al. "Real-Life Use of [68Ga]Ga-DOTANOC PET/CT in Confirmed and Suspected NETs from a Prospective 5-Year Electronic Archive at an ENETS Center of Excellence: More Than 2000 Scans in More Than 1500 Patients." Cancers (Basel), 2024;16(4). PMID: 38398092.
- [clinical-trial] Wild D, et al. "Comparison of 68Ga-DOTANOC and 68Ga-DOTATATE PET/CT within patients with gastroenteropancreatic neuroendocrine tumors." J Nucl Med, 2013;54(3):364-72. PMID: 23297077.
- [pubmed] Kabasakal L, et al. "Comparison of ⁶⁸Ga-DOTATATE and ⁶⁸Ga-DOTANOC PET/CT imaging in the same patient group with neuroendocrine tumours." Eur J Nucl Med Mol Imaging, 2012;39(8):1271-7. PMID: 22526963.
- [review] Wijaya RR, et al. "Comparison of radiolabeled somatostatin analogs (DOTATATE, DOTANOC, and DOTATOC) in somatostatin receptor (SSTR) imaging for gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs): a narrative literature review." Ann Nucl Med, 2025;39(8):755-773. PMID: 40580373.
- [pubmed] Ansquer C, et al. "Head-to-Head Comparison of 18F-DOPA PET/CT and 68Ga-DOTANOC PET/CT in Patients With Midgut Neuroendocrine Tumors." Clin Nucl Med, 2021;46(3):181-186. PMID: 33315677.
- [pubmed] Viswanathan R, et al. "Head-to-Head Comparison of SSTR Antagonist [(68)Ga]Ga-DATA(5m)-LM4 with SSTR Agonist [(68)Ga]Ga-DOTANOC PET/CT in Patients with Well Differentiated Gastroenteropancreatic Neuroendocrine Tumors: A Prospective Imaging Study." Pharmaceuticals (Basel), 2024;17(3). PMID: 38543061.
- [clinical-trial] Singh D, et al. "Role of [68Ga]DOTANOC PET/computed tomography and [131I]MIBG scintigraphy in the management of patients with pheochromocytoma and paraganglioma: a prospective study." Nucl Med Commun, 2020;41(10):1047-1059. PMID: 32732602.
- [pubmed] Lamarca A, et al. "68Gallium DOTANOC-PET Imaging in Lung Carcinoids: Impact on Patients' Management." Neuroendocrinology, 2018;106(2):128-138. PMID: 28399530.
- [pubmed] Goroshi MR, et al. "Comparison of 68Ga-DOTANOC PET/CT and contrast-enhanced CT in localisation of tumours in ectopic ACTH syndrome." Endocr Connect, 2016;5(2):83-91. PMID: 27006371.
- [clinical-trial] Kundu P, et al. "Prospective evaluation of (68)Ga-DOTANOC PET-CT in differentiated thyroid cancer patients with raised thyroglobulin and negative (131)I-whole body scan: comparison with (18)F-FDG PET-CT." Eur J Nucl Med Mol Imaging, 2014;41(7):1354-62. PMID: 24562651.
- [pubmed] Solanki R, et al. "Diagnostic performance of 68 Ga-DOTANOC PET/computed tomography in cardiac sarcoidosis: comparison with 18 F-fluorodeoxyglucose PET/computed tomography and cardiac magnetic resonance." Nucl Med Commun, 2026;47(5):541-551. PMID: 41607278.
- [clinical-trial] Campana D, et al. "Standardized uptake values of (68)Ga-DOTANOC PET: a promising prognostic tool in neuroendocrine tumors." J Nucl Med, 2010;51(3):353-9. PMID: 20150249.
- [review] Al-Adhami D, et al. "First systematic mapping of non-target [68Ga]Ga-DOTANOC uptake across anatomical sites and etiologies." Br J Radiol, 2026;99(1186):2093-2104. PMID: 42568138.
- [pubmed] Prasad V, et al. "Biodistribution of the Ga-68 labeled somatostatin analogue DOTA-NOC in patients with neuroendocrine tumors: characterization of uptake in normal organs and tumor lesions." Q J Nucl Med Mol Imaging, 2010;54(1):61-7. PMID: 20168287.
- [pubmed] Leisser A, et al. "Sex-differences in [(68)Ga]Ga-DOTANOC biodistribution." Nucl Med Biol, 2019;76-77:15-20. PMID: 31654811.
- [clinical-trial] Pettinato C, et al. "68Ga-DOTANOC: biodistribution and dosimetry in patients affected by neuroendocrine tumors." Eur J Nucl Med Mol Imaging, 2008;35(1):72-9. PMID: 17874094.
Sources & Citations
Studies were read from their PubMed abstracts; regulatory status from Drugs@FDA, the EMA medicines list and national medicines information, searched October 29, 2026. The stub's searches (October 28, 2026) found 561 PubMed records and 10 ClinicalTrials.gov studies for DOTANOC, and no Drugs@FDA or EMA record.
Medical Disclaimer: This content is for educational and informational purposes only. It is not medical advice, and nothing here is an instruction to obtain or use any compound. Talk to a licensed clinician about your own situation.