How has the management of medullary thyroid carcinoma changed with the advent of 18F-FDG and non-18F-FDG PET radiopharmaceuticals

Purpose. To perform an overview about the role of positron emission tomography (PET) or PET/computed tomography (PET/CT) using different radiopharmaceuticals in recurrent medullary thyroid carcinoma (MTC) based on biochemical findings (increased tumor marker levels after primary surgery). Methods. A comprehensive literature search of studies published in PubMed/MEDLINE, Scopus, and Embase databases through February 2012 regarding PET or PET/CT in patients with recurrent MTC was performed. Results. Twenty-nine studies comprising 714 patients with suspected recurrent MTC were retrieved. Twenty-seven articles evaluated the role of fluorine-18-fluorodeoxyglucose (FDG) PET or PET/CT in recurrent MTC with conflicting results. Diagnostic accuracy of FDG-PET and PET/CT increased in MTC patients with higher calcitonin and carcinoembryonic antigen values, suggesting that these imaging methods could be very useful in patients with more advanced and aggressive disease. Eight articles evaluated the role of fluorine-18-dihydroxyphenylalanine (FDOPA) PET or PET/CT in recurrent MTC reporting promising results. Overall, FDOPA seems to be superior but complementary compared to FDG in detecting recurrent MTC. Few studies evaluating other PET tracers are also discussed. Conclusions. PET radiopharmaceuticals reflect different metabolic pathways in MTC. FDOPA seems to be the most useful PET tracer in detecting recurrent MTC based on rising levels of tumor markers. FDG may complement FDOPA in patients with more aggressive MTC.

Download Full-text

Predictive Value of 18F-FDG PET in Patients with Advanced Medullary Thyroid Carcinoma Treated with Vandetanib

Journal of Nuclear Medicine ◽

10.2967/jnumed.117.199778 ◽

2017 ◽

Vol 59 (5) ◽

pp. 756-761 ◽

Cited By ~ 14

Author(s):

Rudolf A. Werner ◽

Jan-Stefan Schmid ◽

Takahiro Higuchi ◽

Mehrbod S. Javadi ◽

Steven P. Rowe ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Medullary Thyroid Carcinoma ◽

Predictive Value ◽

Fdg Pet ◽

Medullary Thyroid ◽

18F Fdg

Download Full-text

18F-FDG PET, somatostatin receptor scintigraphy, and CT in metastatic medullary thyroid carcinoma: a clinical study and an analysis of the literature

Nuclear Medicine Communications ◽

10.1097/00006231-200405000-00003 ◽

2004 ◽

Vol 25 (5) ◽

pp. 439-443 ◽

Cited By ~ 42

Author(s):

Martin Gotthardt ◽

Anke Battmann ◽

Helmut H??ffken ◽

Tino Schurrat ◽

Halina Pollum ◽

...

Keyword(s):

Clinical Study ◽

Thyroid Carcinoma ◽

Medullary Thyroid Carcinoma ◽

Fdg Pet ◽

Somatostatin Receptor ◽

Somatostatin Receptor Scintigraphy ◽

Medullary Thyroid ◽

Receptor Scintigraphy ◽

18F Fdg

Download Full-text

The role of 18F-FDG PET/CT in detecting metastatic deposits of recurrent medullary thyroid carcinoma: A prospective study

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2007.08.005 ◽

2008 ◽

Vol 34 (5) ◽

pp. 581-586 ◽

Cited By ~ 47

Author(s):

D. Rubello ◽

L. Rampin ◽

C. Nanni ◽

E. Banti ◽

M. Ferdeghini ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Prospective Study ◽

Medullary Thyroid Carcinoma ◽

Fdg Pet ◽

Medullary Thyroid ◽

Pet Ct ◽

18F Fdg ◽

A Prospective Study ◽

Fdg Pet Ct

Download Full-text

Carcinoembryonic Antigen Increase in a Patient with Colon Cancer Who Have Achieved Complete Remission and Negative 18F-FDG PET/CT: Don’t Forget the Thyroid!

Current Oncology ◽

10.3390/curroncol28040261 ◽

2021 ◽

Vol 28 (4) ◽

pp. 2987-2992

Author(s):

Alexandre Lugat ◽

Pauline Hulo ◽

Catherine Ansquer ◽

Yann Touchefeu ◽

Eric Mirallié ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Carcinoembryonic Antigen ◽

Medullary Thyroid Carcinoma ◽

Fdg Pet ◽

Colon Adenocarcinoma ◽

Medullary Thyroid ◽

Pet Ct ◽

Serum Carcinoembryonic Antigen ◽

18F Fdg ◽

Fdg Pet Ct

Serum carcinoembryonic antigen (CEA) is a tumor marker especially used to follow a patient with colorectal cancer. However, it is non-specific and could be increased in several cancers and some benign conditions. We report the case of a 70-year-old man followed since 2014 for a left colon adenocarcinoma with the persistence of an increased CEA. There was no evidence of recurrence, but a right lobar thyroid nodule without a significantly increased uptake was incidentally discovered on the CT scan of 18F-fluorodeoxyglucose (18F-FDG) PET/CT. We suspected a medullary thyroid carcinoma (MTC) explaining the persistent elevation of CEA. Plasma calcitonin levels were 47 ng/L (N < 10). Fine needle aspiration cytology found atypia of undetermined significance and the patient was reluctant to undergo surgery without any further exploration. We performed a 18F-fluorodihydroxyphenylalanine (18F-FDOPA) PET/CT preoperatively which revealed a punctiform focus of the right thyroid lobe corresponding to a pT1aN1aMxR0 medullary thyroid carcinoma, histopathologically confirmed. This case highlights that despite the potential usefulness of 18F-FDG PET/CT in case of an unknown source of elevated CEA this imaging may be falsely negative as in the case of MTC and should lead to further explorations.

Download Full-text