Hepatopulmonary Shunt Reduction With Lu-177-DOTATATE Therapy

摘要

A 72-year-old man was diagnosed with well-differentiated neuroendocrine tumor of unknown primary with liver metastasis. All liver lesions were detectable only on Ga-68-DOTATATE PET/CT and were negative on F-18-FDG PET/CT. Intrahepatic Y-90 radioembolization therapy was planned, but the hepatopulmonary shunt fraction was found to be 31.6%. Because the hepatopulmonary shunt fraction greater than 20% is an absolute contraindication to radioembolization, we decided to give him Lu-177-DOTATATE therapy. He received 4 courses of Lu-177-DOTATATE and showed regression in posttherapy Ga-68-DOTATATE PET/CT imaging. The hepatopulmonary shunt fraction was reduced to 8% after Lu-177-DOTATATE therapy.