Article Figures & Data
Figures
- FIGURE 1.
177Lu-DOTATATE PRRT administration time line.
- FIGURE 2.
177Lu-DOTATATE Rotterdam secondary pump infusion method. IV = intravenous; Radio Rx = 177Lu-DOTATATE; USP = U.S. Pharmacopeia.
- FIGURE 3.
Example of discordant uptake on 18F-FDG and 68Ga-DOTATOC imaging. Two lesions are visualized: left inguinal node (18F-FDG–positive, minimal 68Ga-DOTATOC uptake) and left ischium bone lesion (68Ga-DOTATOC–positive, 18F-FDG–negative).
- FIGURE 4.
PET/CT imaging 1 h after injection of 68Ga-DOTATATE, and SPECT/CT imaging 96 h after injection of 177Lu-DOTATATE. p.i. = after injection.
Tables
Parameter Exclusion criterion Serum creatinine >150 μmol/L (>1.7 mg/dL) or creatinine clearance < 50 mL/min Hemoglobin <5.0 mmol/L (<8.0 g/dL) White-cell count <2,000/mm3 (2 × 109/L) Platelet count <75,000/mm3 (75 × 109/L) Total bilirubin >3 times upper limit of reference range Serum albumin <25 g/L and prothrombin time increased 1.5 times upper limit of reference range* * Indicates biosynthetic liver failure.
- TABLE 2.
Classification and Grading Criteria for Neuroendocrine Neoplasms of Gastrointestinal Tract and Hepatopancreatobiliary Organs (21)
Terminology Differentiation Grade Mitotic rate Ki-67 index NET, grade 1 Well differentiated Low <2 <3% NET, grade 2 Well differentiated Intermediate 2–20 3%–20% NET, grade 3 Well differentiated High >20 >20% NEC, small-cell type Poorly differentiated High* >20 >20% NEC, large-cell type Poorly differentiated High* >20 >20% MiNEN Well or poorly differentiated Variable† Variable† Variable† ↵* Poorly differentiated neuroendocrine carcinomas are not formally graded but are considered high-grade.
↵† In most mixed neuroendocrine–nonneuroendocrine neoplasms, both neuroendocrine and nonneuroendocrine components are poorly differentiated, and neuroendocrine component has proliferation indices in same range as other neuroendocrine carcinomas, but this conceptual category allows for possibility that one or both components may be well differentiated; when feasible, each component should therefore be graded separately.
MiNEN = mixed neuroendocrine–nonneuroendocrine neoplasm; NEC = neuroendocrine carcinoma.
Mitotic rates are number of mitoses/2 mm2 as determined by counting 50 fields of 0.2 mm2 (i.e., in total area of 10 mm2); Ki-67 proliferation index value is determined by counting at least 500 cells in regions of highest labeling (hot spots), which are identified at scanning magnification; final grade is based on whichever of 2 proliferation indices places neoplasm in higher-grade category.
