Brain Metastasis of Medullary Thyroid Carcinoma Without Macroscopic Calcification Detected First on 68Ga-Dotatate and Then on 18F-Fluoride PET/CT

Duarte, Paulo Schiavom; Marin, José Flávio Gomes; Carvalho, José de Amorim de Willegaignon; Sapienza, Marcelo Tatit; Buchpiguel, Carlos Alberto

doi:10.1097/rlu.0000000000002163

Cited by 7 publications

(4 citation statements)

References 7 publications

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“…68 Ga-DOTATATE PET/CT imaging was performed for staging. [1][2][3] The MIP (A, anteroposterior; B, left lateral) demonstrated multiple foci of abnormal DOTATATE uptake in the medial (thick arrow) and lateral (thin arrow) region of the left neck, as expected. Unsuspectedly, an intense focal uptake was noted in the region of right posterolateral urinary bladder (arrowhead).…”

supporting

confidence: 61%

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Unsuspected Bladder Diverticulum Resulted in False-Positive 68Ga-DOTATATE Uptake

Deng¹,

Deng

He³

et al. 2021

Clin Nucl Med

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A 67-year-old woman with medullary thyroid cancer was referred for a 68Ga-DOTATATE PET/CT scan for staging. The images showed abnormal activity in the left thyroid gland and the left cervical lymph nodes. Surprisingly, increased activity was also noted in the posterolateral aspect of the urinary bladder without corresponding anatomical abnormality. This activity disappeared after urination, suggesting false-positive uptake due to bladder diverticulum.

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supporting

confidence: 61%

“…Pathology biopsy confirmed medullary thyroid carcinoma. 68 Ga-DOTATATE PET/CT imaging was performed for staging 1–3 . The MIP ( A , anteroposterior; B , left lateral) demonstrated multiple foci of abnormal DOTATATE uptake in the medial (thick arrow) and lateral (thin arrow) region of the left neck, as expected.…”

mentioning

confidence: 55%

Unsuspected Bladder Diverticulum Resulted in False-Positive 68Ga-DOTATATE Uptake

Deng¹,

Deng

He³

et al. 2021

Clin Nucl Med

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“…10 Other neoplasms reported to show NaF activity include neurofibroma, 188 meningioma, 189 uterine leiomyoma, 190,191 ovarian cancer, 192 bladder cancer, 193 glioblastoma, 194 and medullary thyroid carcinoma. 195 Certain normal tissues, such as breast tissue, have moderate NaF activity at baseline, 196 which can even be appreciated in druginduced gynecomastia in men. 197 NaF-PET can also show physiologic calcification of intracranial structures, 198,199 as well as heterotopic ossification after surgery.…”

Section: Other Osseous and Soft Tissue Disordersmentioning

confidence: 99%

Novel Musculoskeletal and Orthopedic Applications of 18F-Sodium Fluoride PET

et al. 2021

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The bone-seeking properties of 18 F-sodium fluoride (NaF) were first described in 1962 by Blau and colleagues, 1 who used this positron-emitting radiotracer in skeletal scintigraphy. Both high uptake by bone and rapid plasma clearance of NaF were determined to be advantages in imaging skeletal metabolism. 2 The mechanism of NaF uptake relies on the exchange of OH À for 18 F À , converting hydroxyapatite on the surface of the bone matrix to fluorapatite. 2,3 One hour after NaF is administered intravenously, only 10% remains in the plasma compartment because of a first-pass Conflict of interest: The authors have declared no conflicts of interest.

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“…However, there have been instances in which uptake has been observed in metastatic regions without macroscopic calcium deposition, which could be attributed to visually undetectable calcium accumulation. Indeed, in some cases, macroscopic calcification has been observed in follow-up studies of brain (5) and liver (6) metastatic lesions of MTC that initially presented with 18 F-NaF uptake but no gross calcification on computed tomography (CT) images. Furthermore, in evaluations of atherosclerotic plaque, 18 F-NaF uptake has been linked to the ongoing process of calcium deposition (7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Correlation of 18F-sodium fluoride uptake and radiodensity in extraosseous metastases of medullary thyroid carcinoma

Ueda,

Dias,

Carneiro

et al. 2024

Archives of Endocrinology and Metabolism

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Objective: Although 18 F-sodium fluoride ( 18 F-NaF) uptake is frequently observed in extraosseous metastases of medullary thyroid carcinoma (MTC) with calcification, it can also occur in metastatic sites without visible calcium deposition, leading to the hypothesis that visually undetectable calcium accumulation may be responsible for this uptake. The aim of this study was to indirectly support this hypothesis by analyzing the correlation between the degree of 18 F-NaF uptake and radiodensity in extraosseous MTC metastases, since calcium deposition can increase attenuation even when not visually detectable. Subjects and methods: Extraosseous metastatic lesions of 15 patients with MTC were evaluated using 18 F-NaF positron-emission tomography (PET)/computed tomography (CT) and segmented by levels of standardized uptake value (SUV). The correlation between mean SUV and mean Hounsfield unit (HU) values was assessed for the entire group of segments and for two subgroups with different mean HU values. Results: Very high correlations were observed between mean SUV and mean HU values for both the entire group of segments and the subgroup with a mean HU value greater than 130 (p = 0.92 and p = 0.95, respectively; p < 0.01). High correlation ( p = 0.71) was also observed in the subgroup with mean HU values ranging from 20 to 130 (p < 0.01). Conclusion: The findings of the present study suggest that there is an association between 18 F-NaF uptake and calcium deposition in extraosseous metastases of MTC, supporting the hypothesis that visually undetectable calcium accumulation may be responsible for 18 F-NaF uptake in regions without visible calcium deposition.

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Brain Metastasis of Medullary Thyroid Carcinoma Without Macroscopic Calcification Detected First on 68Ga-Dotatate and Then on 18F-Fluoride PET/CT

Cited by 7 publications

References 7 publications

Unsuspected Bladder Diverticulum Resulted in False-Positive 68Ga-DOTATATE Uptake

Unsuspected Bladder Diverticulum Resulted in False-Positive 68Ga-DOTATATE Uptake

Novel Musculoskeletal and Orthopedic Applications of 18F-Sodium Fluoride PET

Correlation of 18F-sodium fluoride uptake and radiodensity in extraosseous metastases of medullary thyroid carcinoma

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