Occurrence of the Redifferentiation-Akin Phenomenon on ⁶⁸Ga-DOTATATE PET/CT After CAPTEM Chemotherapy in Metastatic Neuroendocrine Tumors with Intermediate MIB1 Index: What Could Be the Molecular Explanation?

Abstract

In this report, we present the ⁶⁸Ga-DOTATATE PET/CT images of a patient with a metastatic neuroendocrine tumor with an intermediate-grade/Ki-67 index who had minimal somatostatin receptor positivity on baseline ⁶⁸Ga-DOTATATE PET/CT but high-grade positivity on somatostatin receptor imaging (Krenning score, III–IV) on follow-up scans after chemotherapy. This redifferentiation-akin phenomenon in intermediate-grade neuroendocrine tumors after chemotherapy can have potential implications for the feasibility of peptide receptor radionuclide therapy in this group of patients in the later phase of their disease course.