Increased 177Lu-DOTATATE uptake in Paget disease

Area of Science:

• Oncology
• Nuclear Medicine
• Radiology

Background:

• A patient with neuroendocrine neoplasm of the ampulla of Vater underwent surgical resection.
• The patient later developed liver metastases, necessitating peptide receptor radionuclide therapy.

Observation:

• During post-therapy whole-body scanning for radionuclide distribution, increased uptake was noted in the hip bone.
• Bone scan and CT imaging were performed to investigate the abnormal uptake.

Findings:

• The hip bone revealed changes consistent with Paget disease.
• The liver lesions showed high accumulation of the radiopharmaceutical, confirming treatment efficacy for metastatic disease.

Implications:

• Diagnostic imaging during cancer therapy can incidentally detect other pathologies.
• This case underscores the importance of thorough interpretation of imaging findings beyond the primary oncologic indication.
• Further investigation may be warranted for patients with unexplained bone uptake during radionuclide therapy.