A 59 year-old female presented for imaging with a history of pancreatic neuroendocrine tumor with liver metastasis.
Images of all performed near the same timepoint.
1: Fused Ga-68 DOTATATE PET/CT;
2: Ga-68 DOTATATE PET Only;
3: Fused FDG PET/CT;
FDG PET Only,
Image 1: The arrows are pointing at the primary pancreatic tail tumor/mass and demonstrates some FDG activity but marked avidity for Ga-68-DOTATATE.
Image 2: The arrow is pointing at one of the hepatic metastatic lesions with central necrosis, no FDG avidity, and peripheral Ga-68 avidity.
Image 3: Nonenhanced CT shows multiple hepatic metastases.
Tumor Differentiation-Dependent PET Radiotracer Uptake Patterns
Well-differentiated neuroendocrine tumors are often seen on Ga 68 SSTR imaging with increased uptake, while poorly-differentiated neuroendocrine tumors tend to be more FDG avid . The same patient may exhibit varying degrees of differentiation.