Al 18 F-NOTA-Octreotide outperforms 18 F-FDG in identifying rare renal metastases from pancreatic neuroendocrine tumor.

We presented a case involving a 56-year-old man who had been experiencing shoulder and back pain for over a year, with extensive bone metastases revealed by a bone scan. To identify the primary source of these issues, the patients underwent a fluorine-18-fluorodeoxyglucose (18 F-FDG) positron emission tomography/computed tomography (PET/CT) scan, which indicated moderate uptake in the right renal soft mass and low uptake in multiple osteolytic lesions. Pathological examination and immunohistochemical staining of the renal mass supported the diagnosis of neuroendocrine tumors. Subsequently, a novel somatostatin receptor imaging agent, Al18 F-NOTA-octreotide (18 F-OC), was performed to further investigate the source of metastatic lesions and to stage the tumor. The 18 F-OC scan revealed a high-uptake lesion in the pancreatic head, as well as additional lymph node and bone metastases lesions.Compared to 18 F-FDG, the 18 F-OC demonstrated superior imaging capabilities and a significantly higher tumor-to-background ratio in neuroendocrine neoplasms, which contributed to improvingthe staging and treatment management.