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02.03.2020 | Image of the Month

Post-therapy imaging of 225Ac-DOTATATE treatment in a patient with recurrent neuroendocrine tumor

verfasst von: Meltem Ocak, Türkay Toklu, Emre Demirci, Nalan Selçuk, Levent Kabasakal

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 11/2020

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Excerpt

Several somatostatin receptor-targeted alpha radionuclide treatments have been introduced, including 225Ac-DOTATATE for advanced progressive metastatic neuroendocrine tumors (NET) [14]. Here we present a 70-year-old man with advanced gastric NET. The patient has a history of gastrectomy and previously treated with multiple cycles of 177Lu-DOTATATE in 7 years with a cumulative dose of 48 GBq. Disease responded partially to the previous 177Lu-DOTATATE treatments except the last cycle. Patient progressed under the sunitinib treatment and could not tolerate the evorolimus. Maximum intensity projection (MIP) and fusion image of 68Ga-DOTATATE positron emission tomography (PET)/computed tomography (CT) show a large mass lesion in the operative bed with high uptake, consistent with progressive disease. Patient was treated with 7 MBq 225Ac-DOTATATE. The post-therapy images were acquired 24 h after the therapy with single-photon emission computed tomography (SPECT)/CT system (Discovery 670, GE). High-energy general-purpose (HEGP) collimators were used for both whole-body and SPECT scan. Both scans were acquired by using 218-keV and 440-keV photon energies with 20% window width. SPECT/CT scan was acquired with 60 projections for 60 s by using 64 × 64 matrix. Whole-body and SPECT/CT images show increased accumulation of 225Ac-DOTATATE in the mass lesion, concordant with 68Ga-DOTATATE PET/CT. The patient responded to treatment clinically and melena stopped 1 week after the treatment. These are the first whole-body and SPECT/CT images which demonstrates high uptake of Ac-225-DOTATATE in tumor tissue. Although there is not enough experience published on use of Ac-225-DOTATATE treatment, these images encourage this type of treatment in patients with NETs. …
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Metadaten
Titel
Post-therapy imaging of 225Ac-DOTATATE treatment in a patient with recurrent neuroendocrine tumor
verfasst von
Meltem Ocak
Türkay Toklu
Emre Demirci
Nalan Selçuk
Levent Kabasakal
Publikationsdatum
02.03.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 11/2020
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-020-04725-x