PMC5729934_01
A, Octreotide scan negative at 4 hours. B, Octreotide scan negative at 24 hours.
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F1
The patient then underwent octreotide scan which was negative (Figures 1a and 1b).
SSTR avidity in liver and small bowel on 68Ga-DOTATATE PET/CT.
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F2
The patient then presented to our institution and was referred for a 68Ga-DOTATATE PET/CT, which was performed soon after the octreotide scan, and demonstrated multiple avid foci throughout the liver, consistent with metastases, as well as two avid foci projecting over the small intestine, likely representing the primary tumor versus lymph node metastasis (Figure 2).
PMC5729934_02
Only hepatic dome lesion visualized on liver triphasic CT.
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F3
Repeat CT triphasic (figure 3) identified an isolated liver metastasis and possible surgical resection was discussed.
SSTR avidity in liver on 68Ga-DOTATATE PET/CT.
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F4
Prior to surgical evaluation, she underwent68Ga-DOTATATE PET/CT, and this study unfortunately demonstrated avidity in the hepatic dome lesion, as well as additional left and right hepatic lobe lesions (Figure 4).
MRI liver with punctate lesion correlating with 68Ga-DOTATATE PET/CT.
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F5
MRI liver was then performed and identified the hepatic dome metastasis, as well as punctate lesions corresponding to the foci of uptake seen on PET (Figure 5).
PMC5729934_03
In addition to lung, liver, and bone disease, thoracic lymph node disease also identified on 68Ga-DOTATOC PET/CT.
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F6
MRI Liver were performed, and, through a clinical trial open at our institution, the patient underwent 68Ga-DOTATOC PET/CT (Figure 6). CT chest demonstrated a left pleural nodule as well as T12 vertebral metastasis. MRI liver demonstrated multiple enlarging hepatic metastases and several unchanged osseous metastases. 68Ga-DOTATOC PET/CT again identified SSTR-positive disease in the bone, liver, and the pleural based lung nodule, but also detected avid posterior mediastinal paraesophageal lymph nodes.