Article Figures & Data
Figures
- FIGURE 1.
Whole-body images of patient 1 at 0.5 h after injection (A), 3 h after injection (B), 24 h after injection (C), and 3 d (71 h) (D) after injection of 161Tb-DOTATOC. Images demonstrated physiologic biodistribution of 161Tb-DOTATOC in liver (Li), spleen (Sp), intestines (Int), and kidneys (Ki) and excretion into urinary bladder (Bl). In addition, accumulation in known osseous metastases (sternal manubrium [blue arrows] and orbital part of frontal bone on left [red arrow]) was visualized. p.i. = after injection.
- FIGURE 2.
Fused coronal SPECT/CT images of patient 1 obtained on the second day after injection of 161Tb-DOTATOC. Images showed pathologic uptake of 161Tb-DOTATOC in osseous metastasis (sternal manubrium [red arrow]) (A) and physiologic uptake of 161Tb-DOTATOC in kidneys (Ki), liver (Li), and spleen (Sp) (B).
- FIGURE 3.
Whole-body images of patient 2 at 0.5 h after injection (A), 2.5 h after injection (B), 20 h after injection (C), and 113 h after injection (D) of 161Tb-DOTATOC. Early blood-pool activity was noted in heart (H) and blood vessels (BV) up to 2.5 h after injection. Physiologic uptake of radiopeptide was observed in soft tissues, liver (Li), kidneys (Ki), intestines (Int) and urinary bladder (Bl). Pathologic accumulation of 161Tb-DOTATOC was demonstrated in bilobar liver (blue arrows) and multifocal osseous metastases (red arrows). p.i. = after injection.
- FIGURE 4.
SPECT/CT images of patient 2 at 19 h after injection of 161Tb-DOTATOC. (A) Coronal section. (B) Sagittal section. (C) Transverse section. Images showed uptake of 161Tb-DOTATOC in bilobar hepatic metastases (yellow arrows) as well as multiple osteoblastic skeletal metastases in vertebral column and pelvis (red arrows). Physiologic uptake of 161Tb-DOTATOC was seen in both kidneys (Ki) as well as in liver (Li).
- FIGURE 5.
PET/CT sagittal section of patient 1 at 60 min after injection of 68Ga-DOTATOC. Pathologic uptake was seen in multiple skeletal metastases (sternal manubrium, left orbital part of frontal bone, occipital bone, and multiple vertebrae [red arrows]). Comparatively higher physiologic uptake of 68Ga-DOTATOC was observed in spleen (Sp). Accumulation of activity in urinary bladder (Bl) was seen because of renal excretion of radiopeptide.
Tables
Characteristic Patient 1 Patient 2 Age (y) 35 70 Sex Male Male Height (cm) 183 193 Body weight (kg) 94 85 Oncologic diagnosis Metastatic, well-differentiated, nonfunctional malignant paraganglioma (initial presentation as right glomus caroticum tumor) Metastatic, functional NEN of pancreatic tail Metastases Lymph node, pulmonary, hepatic, osseous Lymph node, hepatic, pulmonary, osseous, peritoneal Proliferation rate (Ki-67) 5% 4% Initial diagnosis September 2011 September 1996 Genetic predisposition c.301G > T (p.Gly101Trp) heterozygous CDKN2A N/A Karnofsky Performance Score (at time of this study) 90% 80% Previous treatments* Surgery (2011) Surgery (1996/2017) Radiochemotherapy (2011) Chemotherapy (everolimus; 2016) Radionuclide therapy (2017) Radionuclide therapy (2017) ↵* Detailed descriptions of previous treatments are provided in Supplemental Table 1.
N/A = not available.
Characteristic Patient 1 Patient 2 Premedication to prevent adverse effects Ondansetron (8 mg), intravenously Ondansetron (8 mg), intravenously Dexamethasone (8 mg), intravenously Dexamethasone (8 mg), intravenously Measures for nephroprotection Amino acid solution (Lys/Arg) (1,600 mL) intravenously Electrolyte solution (1,000 mL) intravenously Furosemide (20 mg), intravenously Furosemide (20 mg), intravenously Application of 161Tb-DOTATOC 596 MBq, intravenously (July 2018) 1,300 MBq, intravenously (November 2018) Planar scans (whole body) 0.5 h after injection 0.5 h after injection 3 h after injection 2.5 h after injection 24 h after injection 20 h after injection 49.5 h after injection 93 h after injection 71 h after injection 113 h after injection SPECT/CT scan 22.5 h after injection (thorax) 19 h after injection (liver and abdomen) 46 h after injection (thorax) 46.5 h after injection (abdomen and pelvis)
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