Occurrence of ‘Redifferentiation akin’ phenomenon on [⁶⁸Ga]Ga-DOTATATE PET-CT following CAPTEM chemotherapy in Metastatic Neuroendocrine Tumours with intermediate MiB-1 index: what could be the molecular explanation?

Abstract

In this report, we present the [⁶⁸Ga]Ga-DOTATATE PET-CT images (pre- and post-chemotherapy) of a patient with intermediate grade metastatic neuroendocrine tumor (NET) with intermediate grade/Ki-67 index who had minimal somatostatin receptor positivity at baseline [⁶⁸Ga]Ga-DOTATATE PET-CT, but had demonstrated high grade positivity on somatostatin receptor imaging (Krenning score III-IV) on follow-up scan after chemotherapy. This ‘redifferentiation-akin’ phenomenon in intermediate grade NETs following chemotherapy can have potential implications for the feasibility of peptide receptor radionuclide therapy (PRRT) in this group of patients in their course of disease at a later phase.