0:04

The next patient is per gang, uh, patient.

0:09

And this is a straightforward patient.

0:14

This patient had a, a vehicle per gang, again,

0:19

per gang can be evaluated with do.

0:23

It's nice, right?

0:25

Usually we used to, it might PG

0:27

for this patient, if you guys remember.

0:29

And um, it's very nice.

0:32

And um, but Dotatate now is widely replacing, uh, MI BG just

0:37

because pe CT has better image quality,

0:40

better sensitivity than spec ct.

0:42

Um, of course ITM mi BG is an

0:44

or different analog is much, is, is,

0:48

um, an analog, right?

0:51

So it's a different target.

0:53

Bo Bergen gliomas will be usually avid for both

0:58

of them, right?

0:59

Will express the somatostatin receptors

1:02

and uh, the more specific trace tracer is

1:05

of course the MIPG.

1:07

But, um, many, many studies shown that, um,

1:12

both the DOTATATE

1:13

and MIPG uh, perform, uh, similarly equally.

1:18

But the advantage of P ct, um, made most of us, you know,

1:23

move, uh, toward doing preferring PET over uh,

1:28

MR bg just because of the pet advantage as you see here.

1:31

So this is a case of, um, big bargain

1:39

nicely intensely.

1:42

SS the avid here as you see,

1:50

we have other cases of course, when you have a case

1:52

with metastatic disease also, this is very valuable too, um,

1:57

for initial staging for follow up.

1:59

And then also this, this is good for eligibility

2:03

for um, treatment.

2:04

Whether it depends are we gonna treatment?

2:07

I want 31 my pg, so we have to do an RPG scan to assess

2:11

for e are we gonna treat with tthe, which is not,

2:15

it's gonna be off-label treatment.

2:16

So tthe is if they approved for treatment for um, gnet,

2:21

which is gastrointestinal, pancreatic, neuro, the consumer,

2:24

but sometimes it's used as off-label for um, other tumor

2:29

that express malus.

2:33

Otherwise look here through the body, there's nothing else.

2:36

This is just a simple head

2:39

and neck per gang showing you

2:41

that it expresses smash statin receptors.

2:43

Intensity is the other thing is that uh,

2:48

if you are having a patient with neuroendocrin tumor,

2:52

let's say a small bowel mid gut neuroendocrin tumor

2:54

with metastatic with direct nodes and maybe liver meds

2:57

and there's nothing else, and boom,

2:58

There is a focal activity in the head and neck.

3:01

Don't rush and think that this is metastatic cervical lymph

3:03

node because it doesn't make sense, right?

3:05

There's nothing in the mest

3:07

and there's no tracking lymph nodes all the way up

3:09

and it's not gonna just boom pesticides to the, the head

3:12

and neck most think about paragangliomas

3:15

'cause par almost express what's the receptors?

3:17

And they are do avid.

3:19

So keep this in mind, keep that, keep in mind the

3:23

lum must well light up like, uh,

3:26

a light bulb in, uh, ate.

3:30

There's nothing else. This,

3:32

the rest are all physiologic activity, right?

3:37

So the tests, see how it's photonic here nicely.

3:40

This is this.