Ga-68-DOTATOC-PET/CT Identified the Primary Focus of Neuroendocrine Tumors: A Case Report

鎵68-DOTATOC正子電腦斷層造影辨別神經內分泌腫瘤的原發位置：個案報告

蔡席晨(His-Chen Tsai) ； 吳桂芳(Kwai-Fong Wu) ； 謝佳訓(Jason Chia-Hsun Hsieh) ； 王瑜肇(Yu-Chao Wang) ； 陳世欣(Shih-Hsin Chen)

《核子醫學暨分子影像雜誌》 33卷2期 (2020/06) Pp. 99-105

https://doi.org/10.6332/ANMMI.202006_33(2).0004

摘要

Most neuroendocrine tumors (NETs) express somatostatin receptors and can be visualized by Gallium- 68-labeled somatostatin analogs positron emission tomography-computed tomography (PET/CT). We reported a case of metastatic liver NETs receiving Ga-68-DOTATOCPET/ CT, which identified the primary focus. A 34-year-old female suffered from intermittent abdominal pain and liver lesions were found by abdominal sonography. Subsequent CT and magnetic resonance imaging (MRI) revealed hypervascular liver masses and metastatic NETs were confirmed by echo-guided liver biopsy. F-18 fluorodeoxyglucose (FDG)-PET/CT did not find any FDG avid lesions. The patient underwent radiofrequency ablation for the liver lesions, and received long-acting octreotide (20 mg intramuscular) treatment. Ga-68-DOTATOC-PET/CT was then performed and demonstrated the primary focus of the neuroendocrine tumor in the small intestine. Segmental resection of ileum was performed and confirmed the presence of the neuroendocrine tumor, G2. After surgery, the patient's abdominal pain subsided, but kept long-acting octreotide treatment.

關鍵字

Ga-68-DOTATOC ； neuroendocrine tumor ； somatostatin receptor

並列摘要

多數神經內分泌腫瘤表現體抑素受體，因而可以藉由鎵68標記的體抑素類似物正子斷層掃描來檢查。我們報告一例神經內分泌腫瘤合併肝臟轉移的病人，藉由鎵68-DOTATOC正子電腦斷層來辨別原發腫瘤位置。一名34歲女性主訴間歇性腹痛，做了腹部超音波後發現肝臟有腫瘤，電腦斷層以及磁振造影顯示為富血管性的肝臟腫塊，而切片病理報告確診為轉移性神經內分泌腫瘤。氟-18葡萄糖正子電腦斷層並未發現病灶。病人接受了肝臟腫瘤的射頻燒灼術，並使用長效的octreotide治療。為了找出原發腫瘤位置，安排了鎵68-DOTATOC正子電腦斷層，而發現小腸有原發神經內分泌腫瘤。病人隨後接受了迴腸切除術，也確診為病理診斷分期G2的神經內分泌腫瘤。在手術過後，病人不再抱怨腹痛，並持續接受長效octreotide的治療。

並列關鍵字

神經內分泌腫瘤 ； 鎵-68-DOTATOC ； 體抑素受體