68ga-dotanoc and Liver-Neoplasms

Primary lymph node gastrinoma has been defined as gastrin-producing tumor present in lymph nodes and predominantly found in well-defined anatomical region known as gastrinoma triangle. They are usually localized preoperatively with imaging, and their surgical resection results in long-term relief. The authors report a case of unresectable primary lymph nodal gastrinoma with liver metastases in a 14-year-old adolescent boy with proven histopathology detected on Ga-DOTANOC whole-body PET/CT scan followed by preoperative multiple Lu-DOTATATE cycles for cytoreduction. Subsequent surgical resection of residual mass resulted in complete response with a follow-up of around 4 years in this unusual case of Zollinger-Ellison syndrome.

Topics: Adolescent; Gastrinoma; Humans; Liver Neoplasms; Male; Organometallic Compounds; Pancreatic Neoplasms; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals; Zollinger-Ellison Syndrome

Ga-DOTANOC PET/CT confirmed somatostatin receptor (SR) expression in hypervascularized liver lesions suggestive of neuroendocrine tumor that was later diagnosed as hepatocellular carcinoma (HCC). Being highly vascularized on CT, HCC lesions may mimic neuroendocrine tumors. Although HCC is not included among current indications for SR-PET/CT imaging, it may represent a pitfall in image interpretation when studying neuroendocrine tumor patients. Further studies are needed to better ascertain the potential diagnostic role of SR-imaging in HCC.

Topics: Carcinoma, Hepatocellular; Humans; Liver Neoplasms; Organometallic Compounds; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals

Here we report a 31-year-old man with a peri-ampullary neuroendocrine tumor (NET), who underwent Ga DOTANOC-PET/CT for recurrence evaluation, which revealed isolated metastatic lesion in liver segment V. He underwent trans-arterial radio-embolization (TARE) of the isolated hepatic metastasis with Rhenium-microspheres in a lipiodol matrix. The second Ga DOTANOC-PET/CT was performed one month after the TARE therapy revealed resolution of the tracer uptake with good retention of the lipiodol complex replacing the metastasis suggesting a complete response.

Topics: Adult; Embolization, Therapeutic; Humans; Liver Neoplasms; Male; Neuroendocrine Tumors; Organometallic Compounds; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals

We investigated the prognostic role of (68)Ga-DOTANOC in patients affected by hepatic metastases from neuroendocrine tumours (NET) undergoing (90)Y radioembolization ((90)Y-RE).. A group of 15 consecutive patients with unresectable NET liver metastases underwent (68)Ga-DOTANOC PET at baseline and 6 weeks after (90)Y-RE. Molecular response was defined as a reduction of >50% in the tumour-to-spleen ratio (ΔT/S). The patients were divided into two groups (responders with ΔT/S >50% and nonresponders with ΔT/S <50%) Patients were followed up by imaging and laboratory tests every 3 months until death or for at least 36 months following (90)Y-RE. Statistical analysis was performed to identify factors predicting overall survival (OS) and progression-free survival (PFS).. A decrease in T/S ratio was seen in all patients on (68)Ga-DOTANOC PET scans performed after (90)Y-RE. Nine patients were classified as responders and six as nonresponders. The mean OS in all patients was 31.0 months. Responders had a significantly (p < 0.001) longer OS (mean 36.0 ± 2.5 months) and PFS (mean 29.7 ± 3.4 months) than nonresponders. In a multivariate analysis, none of the other examined variables including age, unilobar vs. bilobar locations, bilirubin levels, radiological response or the presence of extrahepatic disease significantly predicted patient outcome.. Molecular response assessed with (68)Ga-DOTANOC PET might be a useful predictor of survival in patients affected by NET liver metastases treated with (90)Y-RE.

Topics: Aged; Biomarkers, Tumor; Cohort Studies; Disease-Free Survival; Embolization, Therapeutic; Female; Gallium Radioisotopes; Humans; Kaplan-Meier Estimate; Liver Neoplasms; Male; Microspheres; Middle Aged; Multimodal Imaging; Neoplasm Metastasis; Neuroendocrine Tumors; Octreotide; Organometallic Compounds; Positron-Emission Tomography; Prognosis; Radiopharmaceuticals; Treatment Outcome; Yttrium

Neuroendocrine tumors (NETs) are rare heterogeneous neoplasm of variable aggressiveness. A 55-year-old woman underwent Ga-DOTANOC PET-CT for suspected NET, which revealed DOTANOC-avid soft tissue mass in the second part of the duodenum with multiple hepatic metastases. Another non-DOTANOC-avid abdominal mass and hypodense lesion in segment VI of the liver were noted. For further evaluation, FDG PET-CT was performed, which revealed increased uptake in the abdominal mass and lesion in segment VI of the liver. Biopsy from the previously mentioned lesions revealed poorly differentiated high-grade NET.

Topics: Female; Fluorodeoxyglucose F18; Humans; Liver Neoplasms; Middle Aged; Neuroendocrine Tumors; Organometallic Compounds; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals