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Research ArticleTeaching Case Study

Metachronous Adenocarcinoma of the Lung in the Setting of Metastatic Gastric Neuroendocrine Tumor: Value of Elucidating Discordance on Dual-Tracer PET/CT with Ki-67 Index

Sarvesh Loharkar and Sandip Basu
Journal of Nuclear Medicine Technology March 2023, 51 (1) 75-77; DOI: https://doi.org/10.2967/jnmt.121.263415
Sarvesh Loharkar
Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, and Homi Bhabha National Institute, Mumbai, India
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Sandip Basu
Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, and Homi Bhabha National Institute, Mumbai, India
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Abstract

Dual-tracer PET/CT (18F-FDG and 68Ga-DOTATATE) has become established practice in the management of metastatic neuroendocrine neoplasms (NENs) and has demonstrated the advantages to patient management of deciphering the molecular PET characteristics of the tumor. Judicious elucidation of the findings is important, especially in scenarios of discordance with reported histopathology, potentially leading to an unsuspected diagnosis such as second primary malignancies. Such a diagnosis established early in the disease course, and mostly at an asymptomatic stage, provides lead time for timely, appropriate management. This concept was elaborated in a case of incidentally detected 18F-FDG–avid metachronous lung adenocarcinoma in a patient with metastatic, well-differentiated gastric NEN, wherein dual-tracer PET/CT showed 18F-FDG–avid but not 68Ga-DOTATATE–avid lung opacity.

  • 18F-FDG
  • 68Ga-DOTATATE
  • dual-tracer PET/CT
  • neuroendocrine neoplasm
  • somatostatin receptor
  • SSTR
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Journal of Nuclear Medicine Technology: 51 (1)
Journal of Nuclear Medicine Technology
Vol. 51, Issue 1
March 1, 2023
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Metachronous Adenocarcinoma of the Lung in the Setting of Metastatic Gastric Neuroendocrine Tumor: Value of Elucidating Discordance on Dual-Tracer PET/CT with Ki-67 Index
Sarvesh Loharkar, Sandip Basu
Journal of Nuclear Medicine Technology Mar 2023, 51 (1) 75-77; DOI: 10.2967/jnmt.121.263415

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Metachronous Adenocarcinoma of the Lung in the Setting of Metastatic Gastric Neuroendocrine Tumor: Value of Elucidating Discordance on Dual-Tracer PET/CT with Ki-67 Index
Sarvesh Loharkar, Sandip Basu
Journal of Nuclear Medicine Technology Mar 2023, 51 (1) 75-77; DOI: 10.2967/jnmt.121.263415
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Keywords

  • 18F-FDG
  • 68Ga-DOTATATE
  • dual-tracer PET/CT
  • neuroendocrine neoplasm
  • somatostatin receptor
  • SSTR
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