Dual Imaging With 68Ga-DOTATOC and 18F-FDG PET for Planning and Follow-up of PRRT in Combination With Temozolomide Treatment in a Patient With a Metastatic Neuroendocrine Tumor.

A 68-year-old man with a metastatic neuroendocrine tumor with unknown primary was found to have partially dedifferentiated metastases according to F-FDG uptake. He received 3 cycles of radiopeptide therapy using [Lu]Lutetium-DOTATATE combined with temozolomide. Before this treatment, the patient had already undergone a series of therapies, including biotherapy, everolimus, 5 cycles of radiopeptide therapies, radiotherapy, and bone-protecting therapy with bisphosphonate and receptor activator of NF-κB ligand, each of which temporarily stalled the progress of the disease. After combined treatment with radiopeptide therapy and temozolomide, the patient showed a very good response in all tumor lesions, including the FDG-positive ones.