PET/CT and Bremsstrahlung Imaging After 90 Y DOTANOC Therapy for Rectal Net With Liver Metastases Ümmühan Abdülrezzak, MD,* Mustafa Kula, MD,* Ahmet Tutuş, MD,* Fikret Buyukkaya, PhD,† and Halit Karaca, MD‡ Abstract: Peptide receptor radionuclide therapy with 177 Lu or 90 Y is prom- ising with successful results in somatostatin receptor–positive tumors. In all radiation therapies, knowledge of the radiation dose received by the target, and other organs in the body is essential to evaluate the risks and benefits of any procedure. We report a case of liver metastases from a rectal neuroen- docrine tumor, which was treated with 90 Y DOTANOC. Posttreatment whole-body planar images were acquired through Bremsstrahlung radi- ations of 90 Y on a γ-camera, and thoracolumbar PET/CT images were acquired on PET. Key Words: 90 Y DOTANOC, peptide receptor radionuclide therapy, liver metastases, rectum neuroendocrine tumor (Clin Nucl Med 2015;40: 799–801) REFERENCES 1. Grassi E, Sghedoni R, Asti M, et al. Radiation protection in 90 Y-labelled DOTA-D-Phe1-Tyr3-octreotide preparations. Nucl Med Commun. 2009;30: 176–182. 2. Cremonesi M, Ferrari M, Paganelli G, et al. Radiation protection in radionu- clide therapies with (90)Y-conjugates: risks and safety. Eur J Nucl Med Mol Imaging. 2006;33:1321–1327. 3. Helisch A, Forster GJ, Reber H, et al. Pre-therapeutic dosimetry and biodistribution of 86 Y-DOTA-Phe1-Tyr3-octreotideversus 111 In-pentetreotide in patients with advanced neuroendocrine tumours. Eur J Nucl Med Mol Imaging. 2004;31:1386–1392. 4. Dancey G, Begent RH, Meyer T. Imaging in targeted delivery of therapy to cancer. Target Oncol. 2009;4:201–217. 5. Cremonesi M, Ferrari M, Zoboli S, et al. Biokinetics and dosimetry in patients administered with (111)In-DOTA-Tyr(3)-octreotide: implications for internal radiotherapy with (90)Y-DOTATOC. Eur J Nucl Med. 1999;26:877–886. 6. Pentlow KS, Finn RD, Larson SM, et al. Quantitative imaging of yttrium-86 with PET. The occurrence and correction of anomalous apparent activity in high density regions. Clin Positron Imaging. 2000;3:85–90. 7. Hofmann M, Maecke H, Borner R, et al. Biokinetics and imaging with the somatostatin receptor PET radioligand (68)Ga-DOTATOC: preliminary data. Eur J Nucl Med. 2001;28:1751–1757. 8. Kowalski J, Henze M, Schuhmacher J, et al. Evaluation of positron emis- sion tomography imaging using [ 68 Ga]-DOTA-D Phe(1)-Tyr(3)-Octreotide in comparison to [ 111 In]-DTPAOC SPECT. Mol Imaging Biol. 2003;5:42–48. Received for publication March 31, 2014; revision accepted May 17, 2015. From the *Department of Nuclear Medicine, School of Medicine, Erciyes Uni- versity, Kayseri; †Çekmece Nuclear Research and Training Center, Turkish Atomic Energy Authority, Istanbul; and ‡Department of Medical Oncology, School of Medicine, Erciyes University, Kayseri, Turkey. PET/CT imaging of 90 Y radionuclide was performed with the Philips Healthcare PET/CT system. 68 Ga synthesis and stability experiments were carried out at the Department of Nuclear Medicine, Erciyes University Hospital, with the supervision of coauthor F.B. All authors approved the final manuscript. Conflicts of interest and sources of funding: none declared. Correspondence to: Ümmühan Abdülrezzak, MD, Department of Nuclear Medicine, School of Medicine, Erciyes University, 38039 Melikgazi/Kayseri, Turkey. E-mail: ummuhan@erciyes.edu.tr. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. ISSN: 0363-9762/15/4010–0799 DOI: 10.1097/RLU.0000000000000894 INTERESTING IMAGE Clinical Nuclear Medicine • Volume 40, Number 10, October 2015 www.nuclearmed.com 799 Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.