Rare Documentation & Theranostic Approach of Renal Metastases from Pancreatic Neuroendocrine Tumour with ¹⁸ F-NOTANOC PET/CT and ¹⁷⁷ Lu-DOTATATE SPECT/CT

A 62-year-old female, a known case of gastroentero-pancreatic neuroendocrine tumours (GEP-NET) with renal metastasis, who underwent somatostatin receptor (SSTR) targeted PET/CT with 18 F-NOTANOC, revealed intense SSTR expression in both primary and metastatic renal lesions. Thereafter, the patient underwent peptide receptor radionuclide therapy (PRRT) with 177 Lu-DOTATATE, post-therapy scan of which showed substantial radiopharmaceutical uptake in the corresponding lesions, highlighting theranostic concordance. Renal metastases from GEP-NET are extremely rare but can occur, often presenting as secondary renal lesions with SSTR-targeted imaging playing a vital role, both for diagnosis and treatment with PRRT, as shown in this patient.