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Fig. 2 | Cancer Imaging

Fig. 2

From: Molecular imaging phenotyping for selecting and monitoring radioligand therapy of neuroendocrine neoplasms

Fig. 2

Monitoring of PRRT using dual tracer approach. A patient with pancreatic NET (G3, Ki-67 30%) with 68Ga-DOTATATE PET (A) showed a large volume of intensely tracer-avid hepatic metastases (bracket) and a pancreatic mass (arrow). Contemporaneous 18F-FDG PET (B) showed some of the hepatic lesions are moderate to intensely avid (bracket) but with no 18F-FDG-avid/non-68Ga-DOTATATE-avid disease; hence the patient was deemed suitable for PRRT. After 4 cycles of 177Lu-DOTATATE, There was a significant reduction in the tumour burden on 68Ga-DOTATATE PET (C, bracket and arrow) and a complete metabolic response on 18F-FDG PET (D, bracket). Despite persisting SSTR-expressing disease, the loss of 18F-FDG avidity suggested an improved prognosis. The patient remained well more than 10-years after initial PRRT despite requiring additional PRRT for relapsing SSTR-expressing disease

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