Interesting ImagesCombined 68Ga-DOTATOC and 18F-FDG PET Predicts a Double Component With Different Grade of a Pancreatic Neuroendocrine Tumor in a Patient With Multiple Endocrine Neoplasia Type 1Paepegaey, Anne-Cécile MD*,†; Gaujoux, Sébastien MD‡; Meyer, Céline MD§; Rouquette, Alexandre MD∥; Libé, Rossella MD*,†Author Information From the *Department of Endocrinology, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris Descartes University †Université Paris Descartes, Sorbonne Paris Cité ‡Department of Endocrine Surgery, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris Descartes University §Department of Nuclear Medicine, Bicetre Hospital, Assistance Publique Hôpitaux de Paris ∥Department of Pathology, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris Descartes University, Paris, France. Received for publication August 20, 2019; revision accepted February 16, 2020. Conflicts of interest and sources of funding: none declared. Correspondence to: Rossella Libé, MD, Hôpital Cochin, Service d’Endocrinologie et des Maladies Métaboliques, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France. E-mail: email@example.com. Online date: April 29, 2020 Clinical Nuclear Medicine: June 2020 - Volume 45 - Issue 6 - p e281-e282 doi: 10.1097/RLU.0000000000003020 Buy Metrics Abstract Managing decisions of pancreatic neuroendocrine tumors (pNETs) can be challenging because of different clinical presentations and prognosis. A 31-year-old woman with multiple endocrine neoplasia type 1, including a suspicious pNET, was assessed with 68Ga-DOTATOC and 18F-FDG PET. A high 68Ga-DOTATOC uptake was visualized in the entire pNET, whereas a high 18F-FDG PET uptake was present only in the upper part of the tumor. After surgery, pathology confirmed the pNET with a double component: an upper grade 2 with a Ki67 of 11% with the high 18F-FDG PET uptake, and a lower grade 1 with a Ki67 of 2%. Combined 68Ga-DOTATOC/18F-FDG PET predicts the grade in heterogeneous pNETs. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.