Flushing, diarrhoea and liver lesions
History
59-year-old woman with 2 years of flushing and diarrhoea; urinary 5-HIAA raised. Liver biopsy: well-differentiated neuroendocrine tumour, Ki-67 6%. CT: small terminal ileal mass, a mesenteric mass with desmoplasia and liver metastases, progressing by RECIST over 12 months on lanreotide 120 mg every 28 days. eGFR 74 mL/min/1.73 m², normal blood count; treated hypertension and type 2 diabetes. Request: ⁶⁸Ga-DOTATATE PET/CT for PRRT assessment.
Step 1 · SSTR PET
The liver metastases (lesion 1) are clearly more avid than normal liver but less than the spleen; the mesenteric mass (lesion 2) is more avid than the spleen. Using the liver and spleen as references, what grade of SSTR expression do they show?
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