My sister had a bilobectomy done today as her atypical carcinoid tumor around 4 cm was located in bronchus intermedius. The doctor removed lymph nodes as well and we are waiting for biopsy report in about 2 weeks. Rapid biopsy during surgery showed clear margins. What I don't understand are the findings of PET/CT scan vs DOTATE she did prior to her surgery. The PET/CT scan shows SUV max uptake of 7.7 while the DOTATE shows uptake of SUV max 5. Why is there a difference and what does this mean. Is the carcinoid more aggressive and histological report will be more adverse and show higher grade. Also, at the end of PET/CT scan it says that it is classified as P4 in the NETPET score. Again what does this mean? Any help would be greatly appreciated.