title: The use of 99mTc-HYNIC-TOC and 18F-FDG PET/CT in the evaluation of duodenal neuroendocrine tumor with atypical and extensive metastasis responding dramatically to a single fraction of PRRT with 177Lu-DOTATATE.
abstract: This report describes a case of extensive diffuse bone marrow involvement with bilateral breast metastases from duodenal neuroendocrine tumor giving rise to a superscan-like appearance on somatostatin receptor-targeted (99m)Tc-hydrazinonicotinamide-TOC scintigraphy. The metastatic lesions demonstrated partial concordance with (18)F-FDG PET/CT findings, signifying varying tumor biology and heterogeneity among metastatic lesions in the same individual, as illustrated with a dual-tracer approach. There was a dramatic symptomatic and biochemical response and better health-related quality of life with a single fraction of peptide receptor radionuclide therapy with (177)Lu-DOTATATE, and radiologically there was stable disease at that point.
authors.affiliation: Radiation Medicine Centre (B.A.R.C.), Tata Memorial Centre, Parel, Mumbai, India drsanb@yahoo.com.
authors.forename: Sandip
authors.initials: S
authors.lastname: Basu
authors.affiliation: Radiation Medicine Centre (B.A.R.C.), Tata Memorial Centre, Parel, Mumbai, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Abhyankar
mesh_terms: D000328:Adult; D004379:Duodenal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D064847:Multimodal Imaging; D009362:Neoplasm Metastasis; D018358:Neuroendocrine Tumors / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy*; D015282:Octreotide / Q000031:analogs & derivatives; D009942:Organometallic Compounds; D015609:Organotechnetium Compounds; D049268:Positron-Emission Tomography; D018000:Receptors, Peptide / Q000378:metabolism*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D009942:Organometallic Compounds; D015609:Organotechnetium Compounds; D018000:Receptors, Peptide; C410263:technetium Tc 99m hydrazinonicotinyl-Tyr(3)-octreotide; D019788:Fluorodeoxyglucose F18; C447941:lutetium Lu 177 dotatate; D015282:Octreotide
keywords: 177Lu-DOTATATE; 18F-FDG PET/CT; 99mTc-HYNIC-TOC scintigraphy; duodenal neuroendocrine tumor