18F-FDG, 68Ga-PSMA, and 64Cu-DOTATATE PET/CT—One Patient, Three Cancers

A 67-year-old man with a history of multiple myeloma, prostate cancer, and rectal carcinoid tumor underwent 18 F-FDG PET/CT for surveillance, which revealed a non–FDG-avid lesion in the liver. To rule out metastasis from prostate cancer and carcinoid tumor, 68 Ga-PSMA and 64 Cu-DOTATATE PET/CT scans were ordered for respective malignancies. The 64 Cu-DOTATATE scan showed radiotracer uptake in the hepatic lesion compatible with metastasis of the carcinoid tumor. Additionally, both 68 Ga-PSMA and 64 Cu-DOTATATE PET/CT scans revealed nodal metastasis within the pelvis. This case highlights the importance of appropriate radiotracer selection in conjunction with patient history in the evaluation of patients with multiple malignancies.