From the Department of Nuclear Medicine, University Hospital Muenster.
Institute of Pathology, Clemenshospital Muenster, Muenster, Germany.
Clin Nucl Med. 2023 Dec 1;48(12):e585-e587. doi: 10.1097/RLU.0000000000004888. Epub 2023 Oct 23.
A 73-year-old man with metastatic pancreatic neuroendocrine tumor was evaluated with 68 Ga-DOTATATE PET/CT for peptide receptor radionuclide therapy. Both PET-positive and negative lesions were seen in the liver, along with extrahepatic metastases. Histopathology was obtained from one of the PET-negative liver lesions to exclude secondary malignancy. Histology confirmed a well-differentiated (G2) metastasis of pNET with high somatostatin receptor expression. We initiated peptide receptor radionuclide therapy with close monitoring of the PET-negative liver metastases. We present a rare case, where posttherapeutic scintigraphy revealed vigorous uptake of 177 Lu-DOTATATE even in the 68 Ga-DOTATATE PET-negative liver metastases. Follow-up PET/CT showed a partial response to therapy.
一位 73 岁男性患有转移性胰腺神经内分泌肿瘤，接受了 68Ga-DOTATATE PET/CT 肽受体放射性核素治疗检查。在肝脏中发现了 PET 阳性和阴性病变，以及肝外转移。从一个 PET 阴性的肝脏病变中获取组织病理学检查结果，以排除继发性恶性肿瘤。组织学证实为分化良好的（G2）pNET 转移，具有高生长抑素受体表达。我们开始进行肽受体放射性核素治疗，并密切监测 PET 阴性肝转移。我们提出了一个罕见病例，治疗后闪烁显像显示 177Lu-DOTATATE 在即使是在 68Ga-DOTATATE PET 阴性的肝转移中也有强烈摄取。后续的 PET/CT 显示对治疗有部分反应。
