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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


1 Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Mumbai, Maharashtra, India
2 Homi Bhabha National Institute, Mumbai, Maharashtra, India

Correspondence Address:
Sandip Basu,
Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Jerbai Wadia Road, Parel, Mumbai - 400 012, Maharashtra
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/wjnm.WJNM_67_20

The correlates of dual tracer positron emission tomography and computed tomography (PET-CT) ( 18 F-fluorodeoxyglucose [ 18 F-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 both18F-FDG and68Ga-DOTATATE, including an uptake equivalent to Krenning score of 3-4 on68Ga-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 on68Ga-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.


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