Choose Your Collimator Wisely: Inappropriate Collimator Selection During a177Lu-DOTATATE Posttreatment Scan

Proper collimator selection is critical to obtaining high-quality, interpretable nuclear medicine images. Collimators help eliminate scatter, which leads to poor spatial resolution and blurry images. We present the case of a posttherapy ¹⁷⁷Lu-DOTATATE (Lutathera) patient who was initially imaged with a low-energy, high-resolution collimator routinely used in ^99mTc imaging. On image review, the patient was reimaged with the appropriate medium-energy, high-resolution collimator, which resulted in improved image quality. When reviewing the quality of images, it is important to understand modifications to the imaging that can significantly improve image quality and interpretation.