Discordant ¹⁸F-FDG and ⁶⁸Ga-DOTATATE PET/CT Findings Before Radionuclide Therapy in Small Cell Lung Cancer.
Shijie Tang, Qinglin Lei, Ya Liu et al.
✦ AI-curated · Sources linked
Case in brief
A 54-year-old man with progressive small cell lung cancer underwent ¹⁸F-FDG and ⁶⁸Ga-DOTATATE PET/CT assessment before radionuclide therapy. The FDG scan evaluated disease extent and identified metabolically active lesions. DOTATATE imaging demonstrated high somatostatin receptor (SSTR) expression in bone lesions and the pancreatic tail, while discordant hepatic uptake suggested tumor heterogeneity. Together, the scans characterized both disease activity and SSTR target expression, informing patient selection and individualized planning for an SSTR-targeted radionuclide therapy-based comprehensive treatment strategy.
What made this case unusual
The two tracers showed discordant hepatic uptake, suggesting intrapatient tumor heterogeneity, alongside high DOTATATE uptake in bone lesions and the pancreatic tail.
Diagnostic / clinical pearl
In this case, FDG and DOTATATE PET/CT provided complementary information: metabolic disease activity and SSTR expression, respectively. Discordant uptake may signal tumor heterogeneity relevant to assessing target expression.