177Lu-DOTATATE (Lutathera) Therapy in 68Ga-DOTATATE PET/CT-Negative Liver Metastases of a Neuroendocrine Tumor
Clinical nuclear medicine(2023)
Abstract
A 73-year-old man with metastatic pancreatic neuroendocrine tumor was evaluated with Ga-68-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 Lu-177-DOTATATE even in the Ga-68-DOTATATE PET-negative liver metastases. Follow-up PET/CT showed a partial response to therapy.
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Key words
PRRT,GEP-NET,PET/CT,DOTATATE,SSTR
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