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. 2023 Jul 21;5(4):e220157. doi: 10.1148/rycan.220157

Figure 8:

Images in a 68-year-old man with metastatic pheochromocytoma treated with four cycles of lutetium 177 (177Lu) tetraazacyclododecane tetraacetic acid octreotate (DOTATATE). A right adrenal pheochromocytoma was resected 2 years previously, with subsequent development of hepatic, osseous, and pulmonary metastasis and inferior vena cava (IVC) tumor thrombus. Selected gallium 68 (68Ga) DOTATATE PET/CT fusion images show a DOTATATE-avid (A) pulmonary metastasis (arrow), (B) IVC tumor thrombus (arrow), and (C) hepatic metastasis (arrow). Following completion of off-label 177Lu-DOTATATE therapy, (D) the pulmonary metastases (arrow), (E) IVC tumor thrombus, and (F) hepatic metastasis decreased in radiotracer uptake level. Central photopenia indicating tumor necrosis increased with the treated hepatic metastasis (E, arrow). SUVmax = maximum standardized uptake volume.

Images in a 68-year-old man with metastatic pheochromocytoma treated with four cycles of lutetium 177 (177Lu) tetraazacyclododecane tetraacetic acid octreotate (DOTATATE). A right adrenal pheochromocytoma was resected 2 years previously, with subsequent development of hepatic, osseous, and pulmonary metastasis and inferior vena cava (IVC) tumor thrombus. Selected gallium 68 (68Ga) DOTATATE PET/CT fusion images show a DOTATATE-avid (A) pulmonary metastasis (arrow), (B) IVC tumor thrombus (arrow), and (C) hepatic metastasis (arrow). Following completion of off-label 177Lu-DOTATATE therapy, (D) the pulmonary metastases (arrow), (E) IVC tumor thrombus, and (F) hepatic metastasis decreased in radiotracer uptake level. Central photopenia indicating tumor necrosis increased with the treated hepatic metastasis (E, arrow). SUVmax = maximum standardized uptake volume.