Medicina Nuclear e Radioterapia

Intraindividual Tumor Heterogeneity in Neuroendocrine Tumors Revealed with 18F-FDG and 68Ga-DOTA-TATE PET/CT

Abstract

Emre Demirci, Betül Vatankulu, Reşit Akyel, Fuat Dede and Metin Halac

68Ga-DOTA-TATE PET/CT is widely used in functional imaging of neuroendocrine tumors (NETs) and is superior to conventional somatostatin receptor scintigraphy (SRS), which is recommended for low grade NETs according to NANETS/ENETS guidelines. On the contrary 18F-FDG PET is suggested in patients with high grade NETs or when SRS is negative. However, tumor heterogeneity is a common finding along with NETs and causes differential expression of somatostatin receptor (sstr) and various FDG metabolisms. Here, we present a case where tumor heterogeneity is revealed with combined use of 18F-FDG PET/CT and 68Ga-DOTA-TATE PET/CT in the same patient and how does it influence clinical decision-making Conclusion: We here present the first report of FFF-VMAT achieving a comparable plan quality with less delivery time to that of FF-VMAT and HT in head and neck cancer. FFF-VMAT is a highly efficient and feasible option for the treatment of head and neck cancer in clinical practice.