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Inicio Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Is it possible NET-redifferentiation after chemotherapy? Ga68 DOTA-peptide imagi...
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Vol. 39. Issue 1.
Pages 31-34 (January - February 2020)
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Vol. 39. Issue 1.
Pages 31-34 (January - February 2020)
Clinical report
Is it possible NET-redifferentiation after chemotherapy? Ga68 DOTA-peptide imaging as a game-changer in therapy management
¿Es posible la rediferenciación de NET tras la quimioterapia? Captación de imágenes de DOTA-Péptidos marcados con Ga68 como cambio de estrategia en el tratamiento terapéutico
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Nurhan Ergüla,
Corresponding author
nurhanergul@yahoo.com

Corresponding author.
, Tevfik Fikret Çermikb, Nevra Dursunc
a Clinic of Nuclear Medicine, Istanbul Training and Research Hospital, Kasap İlyas Mah. Org. Abdurrahman Nafiz Gürman Cd., 34098 Fatih, Istanbul, Turkey
b University of Health Sciences, Clinic of Nuclear Medicine, Istanbul Training and Research Hospital, Kasap İlyas Mah. Org. Abdurrahman Nafiz Gürman Cd., 34098 Fatih, Istanbul, Turkey
c Clinic of Pathology, Istanbul Training and Research Hospital, Kasap İlyas Mah. Org. Abdurrahman Nafiz Gürman Cd., 34098 Fatih, Istanbul, Turkey
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Abstract

A 64-year-old man with pancreatic grade III neuroendocrine carcinoma underwent Ga-68 DOTANOC PET-CT scan for staging. The pancreatic lesion, multiple peripancreatic lymph nodes and multiple gross metastases in both hepatic lobes were revealed with intense uptake. After 3 cycles of chemotherapy containing cisplatin and etoposide the primary and metastatic lesions were decreased in size, however showing higher uptake on follow-up Ga-68 DOTANOC PET-CT scan. Another biopsy from liver demonstrated a significant decrease in Ki-67 proliferation index from 35% to 1%. The patient received 2 cycles of peptide receptor-targeted radionuclide therapy with Lu-177 DOTANOC.

Keywords:
Neuroendocrine tumors
Peptide receptor radionuclide therapy
Ga-68 PET/CT
Redifferentiation
Resumen

Se realizó una PET-TC DOTANOC con Ga-68 a un varón de 64 años con tumor neuroendocrino de grado III, para estadificación. La lesión pancreática, múltiples ganglios peripancreáticos, y diversas metástasis de gran tamaño en ambos lóbulos hepáticos se mostraron con captación intensa. Tras tres ciclos de quimioterapia con cisplatino y etopósido, el tumor primario y las metástasis disminuyeron de tamaño, aunque se reveló una mayor captación en la PET-TC DOTANOC con Ga-68 de seguimiento. Otra biopsia hepática reflejó un descenso significativo del índice de proliferación de Ki-67, del 35 al 1%. El paciente recibió dos ciclos de terapia con radionúclidos de receptores peptídicos con Lu-177 DOTANOC.

Palabras clave:
Tumores neuroendocrinos
Terapia radionucleídica de receptores peptídicos
PET/TC con Ga-68
Rediferenciación

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