我们报告了一名被确诊为具有侵袭性胰腺神经内分泌肿瘤（NET G3; Ki67 = 60%）的患者，该患者接受了胰腺切除术并部分切除了肝部病变。该患者拒绝接受化疗。双探针成像使用18F-FDG和生长抑素受体（SSTR）-靶向PET/CT进行。在两种成像方式中均观察到在双叶肝部病变中的放射性示踪剂积累。开始使用“冷”生长抑素类似物，进行四个周期的肽受体放射性核素治疗（PRRT）后，病情部分缓解。即使在高增殖而有区别的G3 NET（Ki67> 55%）中，也应评估疾病部位中的SSTR表达，这可能允许PRRT成为首线系统性治疗。 版权所有©2023 Wolters Kluwer Health，Inc.保留所有权利。

We report on a patient diagnosed with an aggressive pancreatic neuroendocrine tumor (NET G3; Ki67 = 60%), who underwent pancreatic resection with partial removal of liver lesions. The patient refused chemotherapy. Dual-tracer imaging with 18F-FDG and somatostatin receptor (SSTR)-targeted PET/CT was conducted. Radiotracer accumulation on both imaging modalities in bilobar hepatic lesions was observed. "Cold" somatostatin analogues with four cycles of peptide receptor radionuclide therapy (PRRT) were initiated, leading to partial response. Even in highly proliferative but differentiated G3 NET (Ki67>55%), SSTR expression in sites of disease should be evaluated, which may then allow PRRT, even as first-line systemic treatment.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.