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CC BY-NC-ND 4.0 · World J Nucl Med 2021; 20(01): 125-128
DOI: 10.4103/wjnm.WJNM_67_20
Case Report

Grade 3 metastatic neuroendocrine neoplasms of two unusual primary sites with contrasting differentiation characteristics: Dual tracer positron emission tomography and computed tomography imaging (18F-fluorodeoxyglucose and 68Ga-DOTATATE) correlates and their treatment implications

Sarvesh Loharkar
1   Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, India
2   Homi Bhabha National Institute, Mumbai, Maharashtra, India
,
Sandip Basu
1   Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, India
2   Homi Bhabha National Institute, Mumbai, Maharashtra, India
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Abstract

The correlates of dual tracer positron emission tomography and computed tomography (PET-CT) (18F-fluorodeoxyglucose [18F-FDG] and 68Ga-DOTATATE) in patients of Grade 3 neuroendocrine neoplasms (NENs) are presented. The first, a patient of gall bladder NEN, operated, with histopathology suggestive of high-grade well-differentiated neuroendocrine tumors with MiB-1 labeling index of 35%, showed uptake with both 18F-FDG and 68Ga-DOTATATE, including an uptake equivalent to Krenning score of 3–4 on 68Ga-DOTATATE PET-CT; in the second, a patient of esophageal NEN, Grade 3 with poor differentiation features, with MiB-1 labeling index of 70%, thereby qualifying for Grade 3 neuroendocrine carcinoma, the FDG uptake was high with minimal uptake on 68Ga-DOTATATE PET-CT. The illustrations reiterate the impression that relative uptake of 68Ga-DOTATATE/FDG in the NEN lesions forms a valuable parameter for assessing the dynamic tumor biology in continuum and thus personalizing the treatment strategies.

Keywords

18F-fluorodeoxyglucose positron emission tomography and computed tomography - 68Ga-DOTATATE - dual tracer positron emission tomography and computed tomography - grade 3 - Ki-67/MIB-1 labeling index - neuroendocrine neoplasms

Financial support and sponsorship

Nil.




Publication History

Received: 20 May 2020

Accepted: 04 June 2020

Article published online:
30 March 2022

© 2021. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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