FDG DOTANOC Mismatch in In Vivo Characterization and Grading of Neuroendocrine Tumor

Neuroendocrine tumors (NETs) are rare heterogeneous neoplasm of variable aggressiveness. A 55-year-old woman underwent Ga-DOTANOC PET-CT for suspected NET, which revealed DOTANOC-avid soft tissue mass in the second part of the duodenum with multiple hepatic metastases. Another non-DOTANOC-avid abdominal mass and hypodense lesion in segment VI of the liver were noted. For further evaluation, FDG PET-CT was performed, which revealed increased uptake in the abdominal mass and lesion in segment VI of the liver. Biopsy from the previously mentioned lesions revealed poorly differentiated high-grade NET.