Incidental Visualization of Gallbladder on Post-therapy [¹⁷⁷Lu]Lu-DOTATATE Scintigraphy Mimicking a Liver Metastasis in a Duodenal Neuroendocrine Tumor

Abstract

We present a rare case of physiological uptake of [¹⁷⁷Lu]Lu-DOTATATE in the gallbladder, observed post-therapy, in a 47-year-old man with grade I duodenal neuroendocrine tumor (NET), despite no uptake being observed pre-therapy in the somatostatin receptor-positron emission tomography. On planar scintigraphy, the gallbladder uptake could have been misidentified as liver metastasis. By utilizing single photon emission computed tomography/computed tomography imaging, we were able to precisely localize the tracer and obtain anatomical morphological characteristics, thereby averting the potential for misinterpretation of liver metastasis resulting from the gallbladder's physiological uptake of [¹⁷⁷Lu]Lu-DOTATATE in NET patients.

Keywords

neuroendocrine tumor (NET) - ⁶⁸Ga-DOTATATE; [¹⁷⁷Lu]Lu-DOTATATE - PET-CT - SPECT-CT - somatostatin receptor (SSTR) - peptide receptor radionuclide therapy (PRRT)

Publikationsverlauf

Artikel online veröffentlicht:
04. Juli 2024

• References

• 1 Strosberg JR, Caplin ME, Kunz PL. et al; NETTER-1 investigators. ¹⁷⁷Lu-Dotatate plus long-acting octreotide versus high-dose long-acting octreotide in patients with midgut neuroendocrine tumours (NETTER-1): final overall survival and long-term safety results from an open-label, randomised, controlled, phase 3 trial. Lancet Oncol 2021; 22 (12) 1752-1763
• 2 Gedik GK, Kiratli PO, Erbas B. Visualization of gallbladder with In-111 labeled octreotide in post prandial state. Ann Nucl Med 2006; 20 (08) 557-560
• 3 Katz N, Gilbert LA, Willsey JT. Somatostatin receptor imaging: fatty meal-induced clearance of gallbladder activity. Clin Nucl Med 1997; 22 (01) 58-59
• 4 Diekmann J, Werner RA, Ross TL, Derlin T. Gallbladder visualization in peptide receptor radionuclide therapy with 177Lu-DOTATATE: a potential mimicker of hepatic metastases. Clin Nucl Med 2020; 45 (12) e521-e522
• 5 Araz M, Baltacioglu MH, Saglam S, Ozguven MA, Kucuk NO. Gallbladder uptake mimicking liver metastasis on 177Lu-DOTATATE post-therapy scan gallbladder uptake on 177Lu-DOTATATE scan. Clin Nucl Med 2021; 46 (03) e154-e155
• 6 Anzola LK, Glaudemans AWJM, Dierckx RAJO, Martinez FA, Moreno S, Signore A. Somatostatin receptor imaging by SPECT and PET in patients with chronic inflammatory disorders: a systematic review. Eur J Nucl Med Mol Imaging 2019; 46 (12) 2496-2513
• 7 Fernandez A, Tabuenca O, Peteiro A. A “false positive” octreoscan in ileal Crohn's disease. World J Gastroenterol 2008; 14 (34) 5349-5352
• 8 Vanhagen PM, Krenning EP, Reubi JC. et al. Somatostatin analogue scintigraphy in granulomatous diseases. Eur J Nucl Med 1994; 21 (06) 497-502
• 9 Israel O, Pellet O, Biassoni L. et al. Two decades of SPECT/CT - the coming of age of a technology: An updated review of literature evidence. Eur J Nucl Med Mol Imaging 2019; 46 (10) 1990-2012