Gallbladder Uptake Mimicking Liver Metastasis on 177Lu-DOTATATE Posttherapy Scan Gallbladder Uptake on 177Lu-DOTATATE Scan.

ABSTRACT: We represent the case of a 61-year-old man with atypical carcinoid tumor of the lung. On posttherapy 177Lu-DOTATATE whole-body scan, focal intense uptake in the inferomedial side of the liver was detected. Pretherapy 68Ga-DOTATATE PET/CT showed no sign of liver metastasis, and posttherapy diagnostic dynamic liver MRI is used to exclude metastatic liver disease. Focal intense uptake was attributed to physiological gallbladder uptake.

Analysis of prognostic factors in patients receiving transarterial radioembolization for unresectable hepatocellular carcinoma.

AIM: This study aimed to analyze the prognostic factors of patients receiving transarterial radioembolization for unresectable hepatocellular carcinoma. MATERIAL AND METHOD: Eighty-six (73 M and 13F; mean age: 64.3 ± 9.8 years) patients who received transarterial radioembolization for unresectable hepatocellular carcinoma were included. Relationship between serum alpha-fetoprotein and international normalization ratio level, albumin-bilirubin grade, neutrophil-lymphocyte ratio, presence of portal venous thrombosis and extrahepatic metastases, the dimension of index lesion and OS were analyzed. RESULTS: Neutrophil lymphocyte ratio was ≤ 5 in 76 (88%) and >5 in 10 (12%) of patients. Sixty-two (72%) patients died during a mean of 25.6± 9.7 months follow-up. Mean OS for all patients was calculated as 12.9 ± 14.6 months. In univariate analysis, albumin-bilirubin grade (22.3 ± 3.8 vs. 11.6 ± 4.2; P = 0.03), neutrophil-lymphocyte ratio (21.8 ± 3.6 vs. 7.3 ± 2.6; P =0.04), presence of extrahepatic metastases (30.1 ± 5.4 vs. 7.4 ± 2.0; P = 0.001) and portal venous thrombosis (26.5± 4.8 vs. 10.5 ± 2.1; P = 0.01) had significant effect on OS. In multivariate analysis, serum international normalization ratio (P = 0.005) and alpha-fetoprotein level (P = 0.004), albumin-bilirubin grade (P = 0.05), neutrophil-lymphocyte ratio (P = 0.007), Child-Pugh score (0.006) and presence of ascites (P = 0.005) were significantly correlated with OS. CONCLUSION: Patients with low basal albumin-bilirubin grade and neutrophil-lymphocyte ratio survive longer after transarterial radioembolization for unresectable hepatocellular carcinoma. Presence of extrahepatic metastases and portal venous thrombosis seems to have a prognostic value.