Recently, Hainan Provincial Tumor Hospital introduced a new technology called “⁶⁸Ga-DOTATATE PET/CT Imaging,” employed by its Nuclear Medicine Department to clarify the primary site and metastasis of a rare and complex tumor—neuroendocrine tumor—in a 42-year-old female patient. This provides a reliable basis for subsequent precise diagnosis and treatment.
Hidden “Crisis” Discovered During C-Section
In early 2017, during a cesarean section, Ms. Zhao, who was 36 years old at the time, unexpectedly discovered a large “mass” measuring 10 centimeters in diameter inside her abdomen, diagnosed as “solid pseudopapillary tumor of the pancreas.” After surgical removal and treatment, her condition stabilized.
In September of this year, Ms. Zhao began experiencing frequent lower abdominal pain and symptoms of nausea and vomiting, prompting her to visit Hainan Provincial Tumor Hospital. An abdominal CT scan revealed mass-like lesions in the tail of the pancreas and multiple lesions in the liver and pelvic cavity, raising suspicions of tumor recurrence and metastasis.
However, since “solid pseudopapillary tumor of the pancreas” is classified as a low-grade malignant tumor, the probability of recurrence and metastasis after surgical removal is relatively low. The question remained: Is this indeed a recurrence of the tumor? Are the abnormal masses in the tail of the pancreas and the multiple lesions in the pelvic cavity primary sites or metastatic sites? The diagnostic ambiguities were considerable.
To uncover the “truth,” the doctors performed a puncture biopsy of the lesions near the abdominal wall in the upper abdomen. Surprisingly, the pathological results indicated an extremely rare “neuroendocrine tumor.”
⁶⁸Ga-DOTATATE PET/CT Imaging Technology
Quickly Identifying the "Truth"
Neuroendocrine tumors are a rare heterogeneous group of tumors that originate from peptide-producing neurons and neuroendocrine cells. Due to their widely varying locations and complex, diverse symptoms, diagnosing and treating these tumors has long been a challenge in the fields of medical research and treatment.
To further clarify the origin, staging, and systemic metastasis of her neuroendocrine tumor, Ms. Zhao underwent the latest “⁶⁸Ga-DOTATATE PET/CT imaging examination” (referred to as “⁶⁸Ga-DOTATATE PET/CT Imaging Technology”) upon her doctor’s recommendation.
Professor Yu Lijuan, Director of the Nuclear Medicine Department, stated, “⁶⁸Ga-DOTATATE PET/CT Imaging Technology is currently a very advanced method for detecting neuroendocrine tumors. Octreotide binds with high specificity to somatostatin receptors, reflecting the functionality and expression levels of neuroendocrine cells. This technology plays a crucial role in screening for neuroendocrine tumor lesions, grading and staging, treatment selection, efficacy monitoring, and prognostic assessment, effectively addressing the limitations of conventional imaging examinations and pathological biopsies.”
Professor Yu Lijuan Reviewing Imaging (File Photo)
After Ms. Zhao completed the ⁶⁸Ga-DOTATATE PET/CT imaging examination, it quickly became clear that her neuroendocrine tumor originated from the pancreas. Additionally, a comprehensive investigation of the systemic metastatic lesions was conducted.
With the precise imaging report in hand, on December 5th, Hainan Provincial Tumor Hospital organized a multidisciplinary team of experts from oncology, hepatobiliary and pancreatic surgery, endocrinology, nuclear medicine, and pathology to collaboratively develop an individualized comprehensive treatment plan for Ms. Zhao.
Multiple Advanced Imaging Technologies Fill the Gap in Hainan
It is reported that the successful implementation of “⁶⁸Ga-DOTATATE PET/CT Imaging Technology” at Hainan Provincial Tumor Hospital is attributed to the Nuclear Medicine Departments possession of a cyclotron and drug synthesis system for producing positron-emitting pharmaceuticals. This allows for the independent production of various positron-emitting radioactive drugs. In addition to routine 18F-FDG PET/CT metabolic imaging, the department can also produce a variety of specific PET/CT imaging agents and conduct combined diagnostics using multiple imaging agents, such as 18F-PSMA (Prostate-Specific Membrane Antigen) PET/CT imaging and 18F-AV45 Aβ amyloid imaging.
Currently, by independently producing various positron-emitting radioactive drugs, the Nuclear Medicine Department of Hainan Provincial Tumor Hospital has become the first in the province to carry out precise screening for diseases including neuroendocrine tumors, Alzheimers disease, and prostate cancer, providing cutting-edge nuclear medicine technology for the specific diagnosis and treatment of tumors.
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Written by | Chen Lin