Neuroradiological and Neuropathological Changes After 177Lu-Octreotate Peptide Receptor Radionuclide Therapy of Refractory Esthesioneuroblastoma

Abstract

We describe imaging changes associated with 177Lu-octreotate PRRT of relapsing ENB. To our knowledge, this is the first report describing neuropathological changes associated with this treatment. PRRT is a promising therapeutic option to improve the disease control, and potentially, the survival of patients with refractory ENB.

Efficacy of Peptide Receptor Radionuclide Therapy for Esthesioneuroblastoma

“…High SSR expression in some of these tumors makes a theranostics approach using PRRT a therapeutic option. Outside this series, there are only three single ENB cases treated with PRRT reported in the literature with dates ranging from 2015-2018 (17)(18)(19). Our first patient was treated in 2008 at the PMCC.Our series encompasses complicated and heterogeneous clinical presentations and disease courses.…”

“…This may partly explain the poor response despite high SSR expression. Additionally, patients with ENB who develop retropharyngeal nodal metastasis are known to have a poorer prognosis (18,19,21).…”

The value of 68Gallium‐DOTATATE PET/CT in sinonasal neuroendocrine tumor management: A case series

“…In one of the ENB cases described in this study, 68 Ga‐DOTATATE PET/CT identified a patient who had recurrent ENB with progressive metastatic disease for 177 Lu‐DOTATATE therapy. This is the third case reported in the literature to our knowledge on the use of 68 Ga‐DOTATATE PET/CT to identify a patient with ENB for 177 Lu‐DOTATATE therapy, 29,30 and in a case reported by Adnan et al, a combined protocol of 177 Lu‐DOTATATE and platinum‐based chemotherapy was found to be effective in the management of a high‐grade, recurrent, metastatic sinonasal neuroendocrine carcinoma 23 …”

“…For instance, one case report describes the use of 68 Ga‐DOTANOC PET/CT in accurately delineating sinonasal SNEC, and its role in downstaging from recommendations based on initial contrast‐enhanced CT 27 . The use of 68 Ga‐DOTATATE PET/CT has been described in five reports of ENB to our knowledge 10,11,28‐30 . In one case report, 68 Ga‐DOTATATE PET/CT detected cervical node metastases in an ENB patient with suspicious subcentimeter lymph nodes that were uncertain based on CT alone 10 .…”

“…In another case, 68 Ga‐DOTATATE PET/CT was used for accurate staging of ENB in the sphenoclival region. 68 Ga‐DOTATATE PET/CT has also been used to identify SSTR‐expressing ENB patients for PRRT with 177 Lu‐DOTATATE 29,30 …”