PMC4998245_01
MRI, 18F-FDG PET/CT imaging, and immunostaining for calcitonin in Case 1. A, MRI scan shows a solid 18-mm lesion in the pancreatic tail (arrows), which appears hypointense on T1 and slightly hyperintense on T2. Contrast-enhanced sequences show hypervascularity in arterial phase with persistent enhancement in the subsequent phases. B, 18F-FDG PET/CT (in the upper part of the panel) and 18F-DOPA PET/TC (in the lower part of the panel) both show no significant metabolic activity in the pancreatic lesion. C, Immunostaining of the pancreatic nodule shows intense calcitonin staining (brown). MRI = magnetic resonance imaging.
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F1
Abdominal computed tomography showed a pancreatic nodule (1.8 cm) with moderate enhancement during arterial phase, confirmed on magnetic resonance imaging (Figure 1A) as suggestive of NET. An integrated nuclear medicine approach was undertaken (A.B.): 18F-DOPA PET/CT (Figure 1B - lower panel) revealed mild pancreatic metabolization while 18F-FDG PET/CT (Figure 1B - upper panel) and OctreoScan +SPECT/CT were negative.
Time course of postsurgical calcitonin normalization (solid: Case 1; open: Case 2).
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F2
CgA, synaptophysin and NSE and negative for glucagon, gastrin, insulin, somatostatin, and serotonin. Calcitonin levels normalized rapidly post-surgery (+24 h = 101 pg/mL; +48 h = 3.62 pg/mL; +21 days = 1.31 pg/mL) (Figure 2).
PMC4998245_02
Time course of postsurgical calcitonin normalization (solid: Case 1; open: Case 2).
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F2
CgA, synaptophysin and NSE and negative for glucagon, gastrin, insulin, somatostatin, and serotonin. Calcitonin levels normalized rapidly post-surgery (+24 h = 101 pg/mL; +48 h = 3.62 pg/mL; +21 days = 1.31 pg/mL) (Figure 2).