18 F-FDG and 18 F-AlF-NOTA-octreotide PET/CT in liver infection lesions after operation of duodenal neuroendocrine tumor

18 F-FDG and 18 F-AlF-NOTA-octreotide PET/CT in liver infection lesions after operation of duodenal neuroendocrine tumor | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report 18 F-FDG and 18 F-AlF-NOTA-octreotide PET/CT in liver infection lesions after operation of duodenal neuroendocrine tumor Honghao Xu, Shuzhan Yao, Shuaishuai Xu This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5143420/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Neuroendocrine neoplasms (NEN) arise from the diffuse neuroendocrine cells and most frequently occur in the digestive system. Molecular imaging can allow whole body neoplasm characterization, with sites of well and poorly differentiated disease demonstrated at somatostatin analogs (SSA) PET/CT and FDG PET/CT, respectively. Recently, several studies have confirmed the diagnostic accuracy of dual tracer PET/CT using SSA and FDG. Case presentation: A 63-year-old male patient with duodenal neuroendocrine tumor (NET), Ki-67 proliferation index of 10%, was referred for recurrence detection with dual tracer PET/CT using 18 F-FDG and 18 F-AlF-NOTA-octreotide ( 18 F-OC) six months after operation. Multiple slightly low-density lesions, 18 F-FDG-positive and 18 F-OC-negative, were found in the liver. The hypothesis of metastatic liver NET was made. Subsequent biopsy revealed inflammatory cell infiltration and fibroblast-like cell proliferation in the stroma, and no atypical cell was observed. Conclusions: This case report underscores the importance of understanding the biology and mechanism of both glycometabolism and SSA uptake when interpreting 18F-FDG and SSA PET/CT in NEN. neuroendocrine neoplasm 18F-FDG 18F-AlF-NOTA-octreotide PET/CT Figures Figure 1 Figure 2 Background Neuroendocrine neoplasms (NEN) most frequently occur in the digestive system 1 .They are widely heterogeneous in biological behavior and divided into neuroendocrine tumor (NET), and neuroendocrine carcinoma (NEC) 2 . In NET, cell membrane usually overexpresses somatostatin receptors, resulting the affinity of radiolabeled somatostatin analogs (SSA) 3 . Molecular imaging can allow whole body neoplasm characterization, with sites of well and poorly differentiated disease demonstrated at SSA PET/CT and FDG PET/CT, respectively 4–7 . Recently, several studies have confirmed the diagnostic accuracy of dual tracer PET/CT using SSA and FDG 8–10 . Case Presentation A 63-year-old male patient was referred for a hyper vascular lesion in the ampulla of the duodenum found at contrast-enhanced CT (Fig. 1 ). NET, Ki-67 proliferation index of 10%, was confirmed at radical specimen. Six months after operation, the patient was referred for recurrence detection with dual tracer PET/CT using 18 F-FDG and 18 F-AlF-NOTA-octreotide ( 18 F-OC) (Fig. 2 ). Multiple slightly low-density lesions, 18 F-FDG-positive and 18 F-OC-negative, were found in the liver. The hypothesis of metastatic liver NET was made. Subsequently, ultrasound-guided biopsy revealed inflammatory cell infiltration and fibroblast-like cell proliferation in the stroma, and no atypical cell was observed. Somatostatin receptors are overexpressed on a wide range of NEN cells, providing a unique and specific molecular target for imaging 5 . Somatostatin is a peptide hormone that binds to this receptor, thereby regulating neurotransmission, hormone secretion, and cell proliferation. Octreotide is a synthetic somatostatin analog with a half-life of approximately 90 minutes, much longer than that of somatostatin (2–3 minutes). Several recent studies have confirmed the clinical value of 18 F-AlF-NOTA-octreotide ( 18 F-OC) PET/CT for imaging NEN 8–10 . NEC, on the contrary, are typically not visualized at SSA PET/CT due to the loss of somatostatin receptor expression. Such neoplasms usually have high glycolytic metabolism and therefore are well visualized at 18 F-FDG PET/CT 5 . SSA PET/CT and FDG PET/CT are complementary and help identify both well and poorly differentiated phenotypes, thereby allowing tumor characterization, prognostication and better selection of appropriate management 5 . In the present case, the diagnosis of liver infection lesions was difficult due to the medical history of duodenal NET, although the lesions were negative at 18F-OC PET/CT. SSA PET/CT is a sensitive imaging modality for well-differentiated NEN and indicates a favorable prognosis, whereas FDG PET/CT avidity indicates disease that is potentially more aggressive. Reviewing pathologic findings of radical duodenal specimen, NET of G2 was confirmed. G2 NET can demonstrate high 18F-OC uptake and low glycometabolism, which are in contrast with our PET/CT results. This case report underscores the importance of understanding the biology and mechanism of both glycometabolism and 18F-OC uptake when interpreting 18F-FDG and 18F-OC PET/CT. Conclusions This case report underscores the importance of understanding the biology and mechanism of both glycometabolism and SSA uptake when interpreting 18F-FDG and SSA PET/CT in NEN. Abbreviations NEN, neuroendocrine neoplasms NET, neuroendocrine tumor NEC, neuroendocrine carcinoma SSA, somatostatin analogs 18 F-OC, 18 F-AlF-NOTA-octreotide Declarations Informed consent: Written informed consent was obtained from the patient to participate. Author Contribution guarantors of integrity of entire study, S.X.; study concepts/study design or data acquisition or data analysis/interpretation, all authors; manuscript drafting or manuscript revision for important intellectual content, all authors; approval of final version of submitted manuscript, all authors; agrees to ensure any questions related to the work are appropriately resolved, all authors; literature research, H.X.; and manuscript editing, S.Y., S.X. Acknowledgement The authors thank their colleagues of the department of nuclear medicine of their institute. Data Availability Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study. References Pavel M, Öberg K, Falconi M, et al. Gastroenteropancreatic neuroendocrine neoplasms: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology 2020;31(7):844 − 60. doi: 10.1016/j.annonc.2020.03.304 Rindi G, Mete O, Uccella S, et al. Overview of the 2022 WHO Classification of Neuroendocrine Neoplasms. Endocrine Pathology 2022;33(1):115 − 54. doi: 10.1007/s12022-022-09708-2 Grawe F, Ebner R, Geyer T, et al. Validation of the SSTR-RADS 1.0 for the structured interpretation of SSTR-PET/CT and treatment planning in neuroendocrine tumor (NET) patients. European Radiology 2023;33(5):3416-24. doi: 10.1007/s00330-023-09518-y Johnbeck CB, Knigge U, Kjær A. PET tracers for somatostatin receptor imaging of neuroendocrine tumors: current status and review of the literature. Future oncology (London, England) 2014;10(14):2259-77. doi: 10.2217/fon.14.139 [published Online First: 2014/12/05] Hofman MS, Lau WF, Hicks RJ. Somatostatin receptor imaging with 68Ga DOTATATE PET/CT: clinical utility, normal patterns, pearls, and pitfalls in interpretation. Radiographics : a review publication of the Radiological Society of North America, Inc 2015;35(2):500 − 16. doi: 10.1148/rg.352140164 [published Online First: 2015/03/13] Papadakis GZ, Karantanas AH, Marias K, Millo C. Current status and future prospects of PET-imaging applications in patients with gastro-entero-pancreatic neuroendocrine tumors (GEP-NETs). European journal of radiology 2021;143:109932. doi: 10.1016/j.ejrad.2021.109932 [published Online First: 2021/09/06] Ambrosini V, Caplin M, Castaño JP, et al. Use and perceived utility of [18F]FDG PET/CT in neuroendocrine neoplasms: A consensus report from the European Neuroendocrine Tumor Society (ENETS) Advisory Board Meeting 2022. Journal of neuroendocrinology 2023 doi: 10.1111/jne.13359 Hou J, Long T, He Z, et al. Evaluation of 18F-AlF-NOTA-octreotide for imaging neuroendocrine neoplasms: comparison with 68Ga-DOTATATE PET/CT. EJNMMI Research 2021;11(1) doi: 10.1186/s13550-021-00797-4 Chen D, Yang S, Chen J, et al. Comparison of [18F]-OC PET/CT and contrast-enhanced CT/MRI in the detection and evaluation of neuroendocrine neoplasms. European Journal of Nuclear Medicine and Molecular Imaging 2023;50(8):2420-31. doi: 10.1007/s00259-023-06200-9 Pauwels E, Cleeren F, Tshibangu T, et al. (18)F-AlF-NOTA-Octreotide Outperforms (68)Ga-DOTATATE/NOC PET in Neuroendocrine Tumor Patients: Results from a Prospective, Multicenter Study. Journal of nuclear medicine : official publication, Society of Nuclear Medicine 2023;64(4):632 − 38. doi: 10.2967/jnumed.122.264563 [published Online First: 2022/10/21] Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5143420","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":373612292,"identity":"dfa06b0b-3fd9-47f8-870a-43f6f3f24ed3","order_by":0,"name":"Honghao Xu","email":"","orcid":"","institution":"Shandong Provincial Hospital Affiliated to Shandong First Medical University","correspondingAuthor":false,"prefix":"","firstName":"Honghao","middleName":"","lastName":"Xu","suffix":""},{"id":373612293,"identity":"a6629515-1c57-4007-832a-d6f09093584a","order_by":1,"name":"Shuzhan Yao","email":"","orcid":"","institution":"Shandong Provincial Hospital Affiliated to Shandong First Medical University","correspondingAuthor":false,"prefix":"","firstName":"Shuzhan","middleName":"","lastName":"Yao","suffix":""},{"id":373612294,"identity":"43f8d32a-a60b-44d0-a938-f7f67f0f0030","order_by":2,"name":"Shuaishuai Xu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABCUlEQVRIie2PsUoDQRCG51i4ajXtCsr5CBMWjoALFj6GzS6BtTnbkCLFQeDSCGkPBH0FxRcIDKQ6TJtAirWxTnnFFW4sxbtol2I/dmCL/2PmBwgEjhHhR8MCgO0/Y8V7jJH7u+Iqe342iy0eVGCveKKPghSu+KXoMpLHh/7ONVszn/FUmIK4JA4IE3XbpuC2kj75aUqKrdDvdzylk4WDpb3P2xSRoTA5+ceWQo+uvHKqMcqpVUnKTNa6IfNMUSF0zLicchRdCqyz1CfJvHxvKW44sgMKru1o4FvLV4qHA11ZLnwp1B1dknL4tqkbunhaVf1NPVbXvTmR201U+2G/o/8XDwQCgcAPvgBv/l7ZRh/zlQAAAABJRU5ErkJggg==","orcid":"","institution":"Shandong Provincial Hospital Affiliated to Shandong First Medical University","correspondingAuthor":true,"prefix":"","firstName":"Shuaishuai","middleName":"","lastName":"Xu","suffix":""}],"badges":[],"createdAt":"2024-09-24 08:53:30","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5143420/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5143420/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":68882965,"identity":"e9119d81-2de1-48b1-ab09-5ff66072267f","added_by":"auto","created_at":"2024-11-13 06:17:01","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":1077268,"visible":true,"origin":"","legend":"\u003cp\u003eContrast-enhanced CT found a hyper vascular lesion in the ampulla of the duodenum (A, CT value = 41.4; B, CT value = 78.8; C, CT value = 79.5; D, CT value =77.4; arrows).\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-5143420/v1/5eaf051b9eed8d3f16ae9264.png"},{"id":68882966,"identity":"a564523f-6346-4c37-981d-5975f536c584","added_by":"auto","created_at":"2024-11-13 06:17:01","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":1510822,"visible":true,"origin":"","legend":"\u003cp\u003eDual tracer PET/CT using \u003csup\u003e18\u003c/sup\u003eF-FDG\u003csup\u003e \u003c/sup\u003eand \u003csup\u003e18\u003c/sup\u003eF-AlF-NOTA-octreotide (\u003csup\u003e18\u003c/sup\u003eF-OC) (A, \u003csup\u003e18\u003c/sup\u003eF-FDG MIP; B-C, CT; D-E, \u003csup\u003e18\u003c/sup\u003eF-FDG PET; F-G, \u003csup\u003e18\u003c/sup\u003eF-OC PET; H, \u003csup\u003e18\u003c/sup\u003eF-OC MIP). Multiple slightly low-density lesions (B, 1.2×1.4 cm; C, 1.0×1.1 cm; arrows), 18F-FDG-positive (A; D, SUVmax = 5.8; E, SUVmax = 5.0; arrows) and 18F-OC-negative (F, SUVmax = 1.8; G, SUVmax = 1.7; H; arrows), were found in the liver.\u003c/p\u003e","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-5143420/v1/7cb288a5faf62b169bbe14dc.png"},{"id":69313528,"identity":"858310fa-a22a-4a96-b748-48db9c2ffa38","added_by":"auto","created_at":"2024-11-19 05:32:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2749864,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5143420/v1/a323bcbd-6a4f-4249-833f-8eaa7c520e58.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"18 F-FDG and 18 F-AlF-NOTA-octreotide PET/CT in liver infection lesions after operation of duodenal neuroendocrine tumor","fulltext":[{"header":"Background","content":"\u003cp\u003eNeuroendocrine neoplasms (NEN) most frequently occur in the digestive system\u003csup\u003e1\u003c/sup\u003e.They are widely heterogeneous in biological behavior and divided into neuroendocrine tumor (NET), and neuroendocrine carcinoma (NEC)\u003csup\u003e2\u003c/sup\u003e. In NET, cell membrane usually overexpresses somatostatin receptors, resulting the affinity of radiolabeled somatostatin analogs (SSA)\u003csup\u003e3\u003c/sup\u003e. Molecular imaging can allow whole body neoplasm characterization, with sites of well and poorly differentiated disease demonstrated at SSA PET/CT and FDG PET/CT, respectively\u003csup\u003e4\u0026ndash;7\u003c/sup\u003e. Recently, several studies have confirmed the diagnostic accuracy of dual tracer PET/CT using SSA and FDG\u003csup\u003e8\u0026ndash;10\u003c/sup\u003e.\u003c/p\u003e "},{"header":"Case Presentation","content":" \u003cp\u003eA 63-year-old male patient was referred for a hyper vascular lesion in the ampulla of the duodenum found at contrast-enhanced CT (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). NET, Ki-67 proliferation index of 10%, was confirmed at radical specimen. Six months after operation, the patient was referred for recurrence detection with dual tracer PET/CT using \u003csup\u003e18\u003c/sup\u003eF-FDG and \u003csup\u003e18\u003c/sup\u003eF-AlF-NOTA-octreotide (\u003csup\u003e18\u003c/sup\u003eF-OC) (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Multiple slightly low-density lesions, \u003csup\u003e18\u003c/sup\u003eF-FDG-positive and \u003csup\u003e18\u003c/sup\u003eF-OC-negative, were found in the liver. The hypothesis of metastatic liver NET was made. Subsequently, ultrasound-guided biopsy revealed inflammatory cell infiltration and fibroblast-like cell proliferation in the stroma, and no atypical cell was observed.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eSomatostatin receptors are overexpressed on a wide range of NEN cells, providing a unique and specific molecular target for imaging\u003csup\u003e5\u003c/sup\u003e. Somatostatin is a peptide hormone that binds to this receptor, thereby regulating neurotransmission, hormone secretion, and cell proliferation. Octreotide is a synthetic somatostatin analog with a half-life of approximately 90 minutes, much longer than that of somatostatin (2\u0026ndash;3 minutes). Several recent studies have confirmed the clinical value of \u003csup\u003e18\u003c/sup\u003eF-AlF-NOTA-octreotide (\u003csup\u003e18\u003c/sup\u003eF-OC) PET/CT for imaging NEN\u003csup\u003e8\u0026ndash;10\u003c/sup\u003e. NEC, on the contrary, are typically not visualized at SSA PET/CT due to the loss of somatostatin receptor expression. Such neoplasms usually have high glycolytic metabolism and therefore are well visualized at \u003csup\u003e18\u003c/sup\u003eF-FDG PET/CT\u003csup\u003e5\u003c/sup\u003e. SSA PET/CT and FDG PET/CT are complementary and help identify both well and poorly differentiated phenotypes, thereby allowing tumor characterization, prognostication and better selection of appropriate management\u003csup\u003e5\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eIn the present case, the diagnosis of liver infection lesions was difficult due to the medical history of duodenal NET, although the lesions were negative at 18F-OC PET/CT. SSA PET/CT is a sensitive imaging modality for well-differentiated NEN and indicates a favorable prognosis, whereas FDG PET/CT avidity indicates disease that is potentially more aggressive. Reviewing pathologic findings of radical duodenal specimen, NET of G2 was confirmed. G2 NET can demonstrate high 18F-OC uptake and low glycometabolism, which are in contrast with our PET/CT results. This case report underscores the importance of understanding the biology and mechanism of both glycometabolism and 18F-OC uptake when interpreting 18F-FDG and 18F-OC PET/CT.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis case report underscores the importance of understanding the biology and mechanism of both glycometabolism and SSA uptake when interpreting 18F-FDG and SSA PET/CT in NEN.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eNEN, neuroendocrine neoplasms\u003c/p\u003e\n\u003cp\u003eNET, neuroendocrine tumor\u003c/p\u003e\n\u003cp\u003eNEC, neuroendocrine carcinoma\u003c/p\u003e\n\u003cp\u003eSSA, somatostatin analogs\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e18\u003c/sup\u003eF-OC,\u003csup\u003e\u0026nbsp;18\u003c/sup\u003eF-AlF-NOTA-octreotide\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eInformed consent:\u003c/h2\u003e \u003cp\u003eWritten informed consent was obtained from the patient to participate.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eguarantors of integrity of entire study, S.X.; study concepts/study design or data acquisition or data analysis/interpretation, all authors; manuscript drafting or manuscript revision for important intellectual content, all authors; approval of final version of submitted manuscript, all authors; agrees to ensure any questions related to the work are appropriately resolved, all authors; literature research, H.X.; and manuscript editing, S.Y., S.X.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThe authors thank their colleagues of the department of nuclear medicine of their institute.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eData sharing is not applicable to this article as no datasets were generated or analyzed during the current study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003ePavel M, \u0026Ouml;berg K, Falconi M, et al. Gastroenteropancreatic neuroendocrine neoplasms: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. \u003cem\u003eAnnals of Oncology\u003c/em\u003e 2020;31(7):844\u0026thinsp;\u0026minus;\u0026thinsp;60. doi: 10.1016/j.annonc.2020.03.304\u003c/li\u003e\n\u003cli\u003eRindi G, Mete O, Uccella S, et al. Overview of the 2022 WHO Classification of Neuroendocrine Neoplasms. \u003cem\u003eEndocrine Pathology\u003c/em\u003e 2022;33(1):115\u0026thinsp;\u0026minus;\u0026thinsp;54. doi: 10.1007/s12022-022-09708-2\u003c/li\u003e\n\u003cli\u003eGrawe F, Ebner R, Geyer T, et al. Validation of the SSTR-RADS 1.0 for the structured interpretation of SSTR-PET/CT and treatment planning in neuroendocrine tumor (NET) patients. \u003cem\u003eEuropean Radiology\u003c/em\u003e 2023;33(5):3416-24. doi: 10.1007/s00330-023-09518-y\u003c/li\u003e\n\u003cli\u003eJohnbeck CB, Knigge U, Kj\u0026aelig;r A. PET tracers for somatostatin receptor imaging of neuroendocrine tumors: current status and review of the literature. \u003cem\u003eFuture oncology (London, England)\u003c/em\u003e 2014;10(14):2259-77. doi: 10.2217/fon.14.139 [published Online First: 2014/12/05]\u003c/li\u003e\n\u003cli\u003eHofman MS, Lau WF, Hicks RJ. Somatostatin receptor imaging with 68Ga DOTATATE PET/CT: clinical utility, normal patterns, pearls, and pitfalls in interpretation. \u003cem\u003eRadiographics : a review publication of the Radiological Society of North America, Inc\u003c/em\u003e 2015;35(2):500\u0026thinsp;\u0026minus;\u0026thinsp;16. doi: 10.1148/rg.352140164 [published Online First: 2015/03/13]\u003c/li\u003e\n\u003cli\u003ePapadakis GZ, Karantanas AH, Marias K, Millo C. Current status and future prospects of PET-imaging applications in patients with gastro-entero-pancreatic neuroendocrine tumors (GEP-NETs). \u003cem\u003eEuropean journal of radiology\u003c/em\u003e 2021;143:109932. doi: 10.1016/j.ejrad.2021.109932 [published Online First: 2021/09/06]\u003c/li\u003e\n\u003cli\u003eAmbrosini V, Caplin M, Casta\u0026ntilde;o JP, et al. Use and perceived utility of [18F]FDG PET/CT in neuroendocrine neoplasms: A consensus report from the European Neuroendocrine Tumor Society (ENETS) Advisory Board Meeting 2022. \u003cem\u003eJournal of neuroendocrinology\u003c/em\u003e 2023 doi: 10.1111/jne.13359\u003c/li\u003e\n\u003cli\u003eHou J, Long T, He Z, et al. Evaluation of 18F-AlF-NOTA-octreotide for imaging neuroendocrine neoplasms: comparison with 68Ga-DOTATATE PET/CT. \u003cem\u003eEJNMMI Research\u003c/em\u003e 2021;11(1) doi: 10.1186/s13550-021-00797-4\u003c/li\u003e\n\u003cli\u003eChen D, Yang S, Chen J, et al. Comparison of [18F]-OC PET/CT and contrast-enhanced CT/MRI in the detection and evaluation of neuroendocrine neoplasms. \u003cem\u003eEuropean Journal of Nuclear Medicine and Molecular Imaging\u003c/em\u003e 2023;50(8):2420-31. doi: 10.1007/s00259-023-06200-9\u003c/li\u003e\n\u003cli\u003ePauwels E, Cleeren F, Tshibangu T, et al. (18)F-AlF-NOTA-Octreotide Outperforms (68)Ga-DOTATATE/NOC PET in Neuroendocrine Tumor Patients: Results from a Prospective, Multicenter Study. \u003cem\u003eJournal of nuclear medicine : official publication, Society of Nuclear Medicine\u003c/em\u003e 2023;64(4):632\u0026thinsp;\u0026minus;\u0026thinsp;38. doi: 10.2967/jnumed.122.264563 [published Online First: 2022/10/21]\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"neuroendocrine neoplasm, 18F-FDG, 18F-AlF-NOTA-octreotide, PET/CT","lastPublishedDoi":"10.21203/rs.3.rs-5143420/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5143420/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground: Neuroendocrine neoplasms (NEN) arise from the diffuse neuroendocrine cells and most frequently occur in the digestive system. Molecular imaging can allow whole body neoplasm characterization, with sites of well and poorly differentiated disease demonstrated at somatostatin analogs (SSA) PET/CT and FDG PET/CT, respectively. Recently, several studies have confirmed the diagnostic accuracy of dual tracer PET/CT using SSA and FDG.\u003c/p\u003e\n\u003cp\u003eCase presentation: A 63-year-old male patient with duodenal neuroendocrine tumor (NET), Ki-67 proliferation index of 10%, was referred for recurrence detection with dual tracer PET/CT using \u003csup\u003e18\u003c/sup\u003eF-FDG\u003csup\u003e \u003c/sup\u003eand \u003csup\u003e18\u003c/sup\u003eF-AlF-NOTA-octreotide (\u003csup\u003e18\u003c/sup\u003eF-OC) six months after operation. Multiple slightly low-density lesions, \u003csup\u003e18\u003c/sup\u003eF-FDG-positive and \u003csup\u003e18\u003c/sup\u003eF-OC-negative, were found in the liver. The hypothesis of metastatic liver NET was made. Subsequent biopsy revealed inflammatory cell infiltration and fibroblast-like cell proliferation in the stroma, and no atypical cell was observed.\u003c/p\u003e\n\u003cp\u003eConclusions: This case report underscores the importance of understanding the biology and mechanism of both glycometabolism and SSA uptake when interpreting 18F-FDG and SSA PET/CT in NEN.\u003c/p\u003e","manuscriptTitle":"18 F-FDG and 18 F-AlF-NOTA-octreotide PET/CT in liver infection lesions after operation of duodenal neuroendocrine tumor","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-13 06:16:57","doi":"10.21203/rs.3.rs-5143420/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ae3f9c0d-74cf-47ba-8963-2299204d0380","owner":[],"postedDate":"November 13th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-11-21T09:23:21+00:00","versionOfRecord":[],"versionCreatedAt":"2024-11-13 06:16:57","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5143420","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5143420","identity":"rs-5143420","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}