55-year-old man with well-differentiated, non-functioning metastatic pancreatic neuroendocrine neoplasm. (IMAGE)

Society of Nuclear Medicine and Molecular Imaging

55-year-old man with well-differentiated, non-functioning metastatic pancreatic neuroendocrine neoplasm.

Caption

55-year-old man with well-differentiated, non-functioning metastatic pancreatic NEN and a Ki-67 index of 13%. Patient underwent Whipple procedure, with histologically confirmed G2 pancreatic NEN. MRI had revealed multiple small-volume liver metastases. 68Ga-DOTATATE PET/CT showed very weak DOTATATE-avid small volume lesions in the liver and lymph nodes with extremely low uptake (left), which did not exhibit significant glucose hypermetabolism (second from left). 68Ga-NODAGA-LM3 PET/CT then showed disseminated bilobar liver metastases, demonstrating very intense SSTR antagonist (LM3) uptake in the liver and lymph node metastases (third from left). Patient was treated with four cycles of 177Lu-DOTA-LM3 PRRT with a cumulative administered radioactivity of 25.7 GBq. Restaging 68Ga-NODAGA-LM3 PET/CT scans showed excellent response to 177Lu-DOTA-LM3 PRRT with partial remission of the disease according to RECIST and EORTC criteria (right).

Credit

Image created by Richard P. Baum and Jingjing Zhang, et al,, Theranostics Center for Molecular Radiotherapy and Precision Oncology, ENETS Center of Excellence, Zentralklinik Bad Berka, Bad Berka, Germany.

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