Use of Terbium-161 [ 161 Tb]Tb-DOTATATE in Recurrent Paraganglioma

This report explores the application of terbium-161 [( 161 Tb)Tb] DOTATATE in the case of a 31-year-old man with recurrent paraganglioma. Due to liver metastases and inoperable nodal disease, he was treated with lutetium-177 [( 177 Lu)Lu] DOTATATE, resulting in decreased chromogranin A levels and stable disease. Logistical challenges with lutetium-177 acquisition resulted in treatment with [ 161 Tb]Tb-DOTATATE, demonstrating prominent lesion uptake, further reduction in chromogranin A levels, and no adverse effects. He maintains an excellent functional status and 19 months of progression-free survival after 3 total cycles of [ 177 Lu]Lu and [ 161 Tb]Tb-DOTATATE, suggesting [ 161 Tb]Tb-DOTATATE as a promising alternative radionuclide therapy for advanced neuroendocrine tumors.