PT  - JOURNAL ARTICLE
AU  - Abhiram G. Ashwathanarayana
AU  - Chinmoy K. Biswal
AU  - Ashwani Sood
AU  - Ashwin S. Parihar
AU  - Rakesh Kapoor
AU  - Bhagwant R. Mittal
TI  - Imaging-Guided Use of Combined <sup>177</sup>Lu-DOTATATE and Capecitabine Therapy in Metastatic Mediastinal Paraganglioma
AID  - 10.2967/jnmt.117.197400
DP  - 2017 Dec 01
TA  - Journal of Nuclear Medicine Technology
PG  - 314--316
VI  - 45
IP  - 4
4099  - http://tech.snmjournals.org/content/45/4/314.short
4100  - http://tech.snmjournals.org/content/45/4/314.full
SO  - J. Nucl. Med. Technol.2017 Dec 01; 45
AB  - Peptide receptor radionuclide therapy targets highly expressed somatostatin receptors in well-differentiated neuroendocrine tumors, producing stability or a partial response in most patients with inoperable or metastatic disease. However, neuroendocrine tumors showing increased 18F-FDG uptake have limited treatment options and a poor outcome, and the role of peptide receptor radionuclide therapy is still unclear. Here, we present the case of a young man with mediastinal paraganglioma and extensive metastatic disease showing avidity on both somatostatin receptor imaging and 18F-FDG imaging. The patient experienced a partial response to peptide receptor chemoradionuclide therapy (177Lu-DOTATATE and low-dose capecitabine), as well as a significantly improved quality of life. This case highlights the utility of peptide receptor chemoradionuclide therapy when there is extensive disease avid for both somatostatin receptor and 18F-FDG and a lack of other suitable treatment modalities.