Schmorl nodes can cause increased ⁶⁸Ga DOTATATE activity on PET/CT, mimicking metastasis in patients with neuroendocrine malignancy

Schmorl node (SN) is the herniation of the nucleus pulposus through the cartilaginous and bony endplate into the adjacent vertebral body. It is documented that SNs produce areas of moderately increased ¹⁸F-FDG uptake.We present a case of a patient with history of neuroendocrine tumor, who underwent ⁶⁸Ga DOTATATE PET/CT for follow-up, showing increased focal vertebral uptake suggestive of bone metastasis. CT revealed typical findings of an SN. The presented case indicates that SNs should be considered when encountering focally increased skeletal uptake in ⁶⁸Ga DOTATATE PET/CT studies, which can mimic metastasis in patients with history of neuroendocrine tumors.