RESUMEN
RATIONALE: Functional imaging using radiolabeled somatostatin analogues plays an important role in the management of patients with neuroendocrine tumors, and it is a promising tool in the new era of theragnosis and personalized medicine. PATIENTS CONCERNS: The authors present the case of a 63-year-old woman referred for evaluation of a suspected pancreatic neuroendocrine tumor by Ga-68-DOTA-1-Nal3-octreotide positron emission tomography/computed tomography (Ga-68-DOTA-NOC PET/CT). DIAGNOSES: PET/CT confirmed increased uptake of Ga-68-DOTA-NOC in a pancreatic lesion compatible with hyperexpression of somatostatin receptors in a neuroendocrine tumor. Furthermore, PET/CT revealed increased uptake in a breast lesion and in lymphadenomegalies (less intense than in the pancreatic tumor), which conducted to the incidental diagnosis of a breast carcinoma with lymph node metastases. INTERVENTIONS: For the breast cancer, the patient underwentneoadjuvant chemotherapy and anti-HER2 monoclonal antibody, after which she was submitted to surgery. Regarding thepancreatic neuroendocrine tumor, it was decided to maintain itunder surveillance. OUTCOMES: Breast carcinomas are known to express somatostatin receptors and this is the first report of Ga-68-DOTA-NOC uptake in a breast tumor. LESSONS: Ga-68-DOTA-NOC PET/CT could be useful for the management of breast cancer patients in the new era of theragnosis and personalized medicine.
Asunto(s)
Neoplasias de la Mama/diagnóstico por imagen , Tumores Neuroendocrinos/diagnóstico por imagen , Compuestos Organometálicos , Neoplasias Pancreáticas/diagnóstico por imagen , Tomografía Computarizada por Tomografía de Emisión de Positrones , Radiofármacos , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/patología , Neoplasias de la Mama/cirugía , Carcinoma/diagnóstico por imagen , Carcinoma/tratamiento farmacológico , Carcinoma/patología , Carcinoma/cirugía , Femenino , Humanos , Hallazgos Incidentales , Linfadenopatía/diagnóstico por imagen , Persona de Mediana EdadRESUMEN
We present the case of a patient with history of colon cancer, referred for the evaluation of indeterminate pulmonary nodules by F-FDG PET/CT. A dual-time point protocol was performed, and images were reconstructed using VUE Point HD and a Bayesian-penalized likelihood reconstruction algorithm (Q.Clear). Visually, the quality of the images was considered better when Q.Clear was used with ß value of 200, uptake in the smallest nodule (7 mm) was clearly visible only with Q.Clear reconstruction, and uptake in the smaller nodules was best defined in the delayed time point acquisition. Quantitative parameters were also higher for Q.Clear.