0:01

64-year-old male with

0:05

a pancreatic mass that was diagnosed

0:08

as a well differentiated neuroendocrine tumor.

0:12

DYS disparity was performed for staging.

0:16

Looking at the mip, we can see that there are multiple areas

0:20

of abnormal tracer uptake in the liver.

0:24

There is, uh, very abnormal uptake in the

0:28

upper abdomen as well.

0:30

And so we're gonna go through all these findings on the

0:35

axial plane.

0:37

So starting with the pancreatic mass,

0:43

there is a large heterogeneous pancreatic mass.

0:47

As we can see on the pit,

0:49

there is intense peripheral uptake.

0:52

The center of the lesion has no tracer uptake.

0:57

This mass is centered at the tail of the pancreas,

1:01

but is locally aggressive

1:03

and extends into the splenic hilum as we can see on the CT

1:09

and also in a heterogeneous way on the pit,

1:14

as well as extends toward the left

1:18

pararenal space and involves the left kidney.

1:25

This was the biopsy proven pancreatic neuroendocrine.

1:29

It's well differentiated

1:31

because we can see that there is intense TA uptake.

1:35

Other areas of abnormality are all these multiple

1:40

lesions in the liver.

1:41

Some are large like this one on the left helo with central

1:47

NIA and hypo density on ct.

1:51

And some are smaller like this one

1:54

on the edge anteriorly,

1:56

which has a very subtle correlate on the CT

2:00

portion of this study.

2:03

As I mentioned earlier, the MIB images allow us to see areas

2:07

that may be obscured if we scroll through in axial plane.

2:12

And I want to point your attention to this area,

2:17

focal uptake that projects anteriorly into the patient's

2:20

body, that it's subtle

2:23

and I really have to force the window here to see it better.

2:28

These correlated to a soft tissue nodule on the

2:33

left anterior abdominal wall.

2:36

And so, uh, not only we were able to identify, in this case

2:41

the metastatic disease

2:44

and the local involvement

2:47

of the pancreatic mass into the spleen and kidney,

2:51

but we also identified an additional soft tissue metastasis.

2:57

We went back to priors and this was a new finding

3:00

and this showed enhancement on a CT abdomen

3:05

demonstrating that this was not a benign finding,

3:09

but a soft tissue metastasis.

DOTATATE Case: Pancreatic NET

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Interactive Transcript

Pro Tip: Click on a word in the transcript to jump to that point in the video

0:01

64-year-old male with

0:05

a pancreatic mass that was diagnosed

0:08

as a well differentiated neuroendocrine tumor.

0:12

DYS disparity was performed for staging.

0:16

Looking at the mip, we can see that there are multiple areas

0:20

of abnormal tracer uptake in the liver.

0:24

There is, uh, very abnormal uptake in the

0:28

upper abdomen as well.

0:30

And so we're gonna go through all these findings on the

0:35

axial plane.

0:37

So starting with the pancreatic mass,

0:43

there is a large heterogeneous pancreatic mass.

0:47

As we can see on the pit,

0:49

there is intense peripheral uptake.

0:52

The center of the lesion has no tracer uptake.

0:57

This mass is centered at the tail of the pancreas,

1:01

but is locally aggressive

1:03

and extends into the splenic hilum as we can see on the CT

1:09

and also in a heterogeneous way on the pit,

1:14

as well as extends toward the left

1:18

pararenal space and involves the left kidney.

1:25

This was the biopsy proven pancreatic neuroendocrine.

1:29

It's well differentiated

1:31

because we can see that there is intense TA uptake.

1:35

Other areas of abnormality are all these multiple

1:40

lesions in the liver.

1:41

Some are large like this one on the left helo with central

1:47

NIA and hypo density on ct.

1:51

And some are smaller like this one

1:54

on the edge anteriorly,

1:56

which has a very subtle correlate on the CT

2:00

portion of this study.

2:03

As I mentioned earlier, the MIB images allow us to see areas

2:07

that may be obscured if we scroll through in axial plane.

2:12

And I want to point your attention to this area,

2:17

focal uptake that projects anteriorly into the patient's

2:20

body, that it's subtle

2:23

and I really have to force the window here to see it better.

2:28

These correlated to a soft tissue nodule on the

2:33

left anterior abdominal wall.

2:36

And so, uh, not only we were able to identify, in this case

2:41

the metastatic disease

2:44

and the local involvement

2:47

of the pancreatic mass into the spleen and kidney,

2:51

but we also identified an additional soft tissue metastasis.

2:57

We went back to priors and this was a new finding

3:00

and this showed enhancement on a CT abdomen

3:05

demonstrating that this was not a benign finding,

3:09

but a soft tissue metastasis.

Report

Faculty

Elisa Franquet Elia, MD

Assistant Professor of Radiology

UMass Chan Medical School

Lesson

Introduction to PET/CT Imaging

Lesson

FDG Use in PET/CT

Lesson

FDG: Common Pitfalls and Benign Lesions

Lesson

FDG Use in Hematologic Malignancies

Lesson

FDG Use in Lung Cancer

Lesson

FDG Use in Head & Neck Cancer

Lesson

FDG Use in Breast Cancer

Lesson

FDG Use in Immunotherapy

Lesson

DOTATATE Use in PET/CT

Lesson

DOTATATE and FDG Use in Neuroendocrine Tumors

Lesson

PSMA Use in PET/CT

Lesson

PSMA Use in Prostate Cancer

DOTATATE Case: Pancreatic NET