BACKGROUND: Pancreatic neuroendocrine tumor (PNET) is a subgroup of neuroendocrine tumor (NET) that has unique biology and natural history. The histological classification has a major role in the management of this pathology, but in recent years Gallium 68 dotatate (68Ga-DOTA) scanning is at the center of a discussion about how these imaging technologies can modify clinical management of neuroendocrine tumors and how their results are correlated to Ki67 index. METHOD: We hereby describe a case of a patient that investigated an unspecific stable pancreatic nodule suspected of high-grade NET after evaluation with 68Ga-DOTATOC positron emission tomography-computed tomography (PETCT) and 18F-Fluorodeoxyglucose (18F-FDG) PETCT. RESULTS: The images corroborate the hypothesis of high-grade NET based on the standard uptake value (SUV) described in both image exams (16.4 in 18FDG PETCT and 9.2 in 68Ga-DOTATOC PETCT). After surgery, the histopathological analyses revealed a localized grade 2 well-differentiated NET, Ki-67 of 4.7, glucose transport proteins 1 (GLUT1) negative by immunohistochemistry, evidencing a rare case of mismatch between the functional image and the in vivo characterization of the neoplasm. CONCLUSION: Functional imaging of neuroendocrine tumors with different modalities of PETCT is a well-described strategy for evaluating PNET and can dictate conducts in some cases. However, histopathological analysis is crucial to confirm the grade and prognosis related to this disease.
BACKGROUND:Pancreatic neuroendocrine tumor (PNET) is a subgroup of neuroendocrine tumor (NET) that has unique biology and natural history. The histological classification has a major role in the management of this pathology, but in recent years Gallium 68 dotatate (68Ga-DOTA) scanning is at the center of a discussion about how these imaging technologies can modify clinical management of neuroendocrine tumors and how their results are correlated to Ki67 index. METHOD: We hereby describe a case of a patient that investigated an unspecific stable pancreatic nodule suspected of high-grade NET after evaluation with 68Ga-DOTATOC positron emission tomography-computed tomography (PETCT) and 18F-Fluorodeoxyglucose (18F-FDG) PETCT. RESULTS: The images corroborate the hypothesis of high-grade NET based on the standard uptake value (SUV) described in both image exams (16.4 in 18FDG PETCT and 9.2 in 68Ga-DOTATOC PETCT). After surgery, the histopathological analyses revealed a localized grade 2 well-differentiated NET, Ki-67 of 4.7, glucose transport proteins 1 (GLUT1) negative by immunohistochemistry, evidencing a rare case of mismatch between the functional image and the in vivo characterization of the neoplasm. CONCLUSION: Functional imaging of neuroendocrine tumors with different modalities of PETCT is a well-described strategy for evaluating PNET and can dictate conducts in some cases. However, histopathological analysis is crucial to confirm the grade and prognosis related to this disease.
Authors: Laura Evangelista; Ilaria Ravelli; Antonio Bignotto; Diego Cecchin; Pietro Zucchetta Journal: Clin Imaging Date: 2020-06-09 Impact factor: 1.605
Authors: Wouter A P Breeman; Marion de Jong; Erik de Blois; Bert F Bernard; Mark Konijnenberg; Eric P Krenning Journal: Eur J Nucl Med Mol Imaging Date: 2005-01-18 Impact factor: 9.236
Authors: Melpomeni Fani; Luigi Del Pozzo; Keelara Abiraj; Rosalba Mansi; Maria Luisa Tamma; Renzo Cescato; Beatrice Waser; Wolfgang A Weber; Jean Claude Reubi; Helmut R Maecke Journal: J Nucl Med Date: 2011-06-16 Impact factor: 10.057
Authors: Michael Gabriel; Clemens Decristoforo; Dorota Kendler; Georg Dobrozemsky; Dirk Heute; Christian Uprimny; Peter Kovacs; Elisabeth Von Guggenberg; Reto Bale; Irene J Virgolini Journal: J Nucl Med Date: 2007-04 Impact factor: 10.057
Authors: I Buchmann; M Henze; S Engelbrecht; M Eisenhut; A Runz; M Schäfer; T Schilling; S Haufe; T Herrmann; U Haberkorn Journal: Eur J Nucl Med Mol Imaging Date: 2007-05-23 Impact factor: 9.236