Clinical Relevance of <sup>18</sup>F-FDG PET and <sup>18</sup>F-DOPA PET in Recurrent Medullary Thyroid Carcinoma

Verbeek, Hans H. G.; Plukker, John; Koopmans, Klaas Pieter; Groot, Jan Willem B. de; Hofstra, Robert; Kobold, Anneke C. Muller; Horst-Schrivers, Anouk N A van der; Brouwers, Adrienne H.; Links, Thera P.

doi:10.2967/jnumed.112.105940

Cited by 86 publications

(53 citation statements)

References 29 publications

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“…On the other hand, this pooled sensitivity should be considered significant, because [ 18 F]DOPA PET and PET/ CT are often performed in patients with suspected recurrent MTC after negative findings on conventional imaging studies. In fact, in most cases, patients are referred for [ 18 F]DOPA PET or PET/CT because of rising levels of calcitonin, a very sensitive and specific tumor marker for [32][33][34][35][36][37][38][39]41].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of [18F]DOPA PET and PET/CT in patients with neuroendocrine tumors: a meta-analysis

Rufini

Treglia

Montravers

et al. 2013

Clin Transl Imaging

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Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of [18F]DOPA PET and PET/CT in patients with neuroendocrine tumors: a meta-analysis

Rufini

Treglia

Montravers

et al. 2013

Clin Transl Imaging

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“…After initial surgery, serum calcitonin is still detectable in nearly 20% of patients, suggesting residual disease, and imaging including neck ultrasonography, neck and chest CT, liver contrast-enhanced CT or MRI, and spine and pelvic bone MRI is recommended when serum calcitonin is higher than 150 pg/mL (1,2). With the ability to characterize and quantify cancer molecular processes, 18 F-DOPA or 18 F-FDG PET/CT also show high performance in relapsed MTC patients and great potential as surrogate biomarkers, useful for early response evaluation and prediction of clinical outcome (3)(4)(5)(6).…”

mentioning

confidence: 99%

Immuno-PET Using Anticarcinoembryonic Antigen Bispecific Antibody and ⁶⁸Ga-Labeled Peptide in Metastatic Medullary Thyroid Carcinoma: Clinical Optimization of the Pretargeting Parameters in a First-in-Human Trial

et al. 2016

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Earlier clinical studies reported a high sensitivity of pretargeted immunoscintigraphy using murine or chimeric anticarcinoembryonic antigen (CEA) bispecific antibody (BsMAb) and peptides labeled with 111 In or 131 I in medullary thyroid carcinoma (MTC). Preclinical studies showed that new-generation humanized recombinant anti-CEA · antihistamine-succinyl-glycine (HSG) trivalent BsMAb TF2 and radiolabeled HSG peptide (IMP288) present good features for PET. This study aimed at optimizing molar doses and pretargeting interval of TF2 and 68 Ga-labeled IMP288 for immuno-PET in relapsed MTC patients with calcitonin serum levels greater than 150 pg/mL. Methods: Five cohorts (C1-C5) of 3 patients received variable molar doses of TF2 and approximately 150 MBq of 68 Ga-IMP288 after different pretargeting time intervals (C1: 120 nmol TF2, 6 nmol IMP288, 24 h; C2: 120 nmol TF2, 6 nmol IMP288, 30 h; C3: 120 nmol TF2, 6 nmol IMP288, 42 h; C4: 120 nmol TF2, 3 nmol IMP288, 30 h; and C5: 60 nmol TF2, 3 nmol IMP288, 30 h). TF2 and 68 Ga-IMP288 pharmacokinetics were monitored. Whole-body PET was recorded 60 and 120 min after 68 Ga-IMP288 injection. Tumor maximal SUV (T-SUV max ) and T-SUV max -to-mediastinum blood-pool (MBP) SUV mean ratios (T/ MBP) were determined. Results: In C1, T-SUV max and T/MBP ranged from 4.09 to 8.93 and 1.39 to 3.72 at 60 min and 5.14 to 11.25 and 2.73 to 5.38 at 120 min, respectively. Because of the high MBP, the delay was increased to 30 h in C2, increasing T-SUV max and T/MBP. Further increasing the delay to 42 h in C3 decreased T-SUV max and T/ MBP, showing that 30 h was the most favorable delay. In C4, the TF2-to-peptide mole ratio was increased to 40 (delay 30 h), resulting in high T-SUV max but with higher MBP than in C2. In C5, the molar dose of TF2 was reduced, resulting in lower imaging performance. Pharmacokinetics demonstrated a fast TF2 clearance and a clear relationship between blood activity clearance and the ratio between the molar amount of injected peptide to the molar amount of circulating TF2 at the time of peptide injection. Conclusion: High tumor uptake and contrast can be obtained with pretargeted anti-CEA immuno-PET in relapsed MTC patients, especially using optimized pretargeting parameters: a BsMAb-to-peptide mole ratio of 20 and 30 h pretargeting delay. Medul lary thyroid carcinoma (MTC) is relatively infrequent, accounting for less than 10% of all thyroid cancers (1). After initial surgery, serum calcitonin is still detectable in nearly 20% of patients, suggesting residual disease, and imaging including neck ultrasonography, neck and chest CT, liver contrast-enhanced CT or MRI, and spine and pelvic bone MRI is recommended when serum calcitonin is higher than 150 pg/mL (1,2). With the ability to characterize and quantify cancer molecular processes, 18 F-DOPA or 18 F-FDG PET/CT also show high performance in relapsed MTC patients and great potential as surrogate biomarkers, useful for early response evaluation and prediction of clinical outcome (3-6).MTC is characterized by an ...

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“…Also, sensitivity of FDG-PET/CT improves in patients with shorter serum calcitonin and CEA doubling times, confirming the usefulness of this imaging method in patients with more aggressive disease compared to those with comparatively slowly progressive disease [9,13]. In particular, FDG-PET has a relevant prognostic value as it is able to identify MTC patients with poor survival [14,15].…”

Section: B)mentioning

confidence: 57%

The 2015 Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma: the “evidence-based” refusal to endorse them by EANM due to the “not evidence-based” marginalization of the role of Nuclear Medicine

Treglia

Aktolun²,

Chiti

et al. 2016

Eur J Nucl Med Mol Imaging

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In 2007, the American Thyroid Association (ATA) assembled a group of expert clinicians and basic scientists to evaluate published papers and to develop evidence-based guidelines for the diagnosis and management of patients with medullary thyroid carcinoma (MTC). The first ATA guidelines on the management of patients with MTC were published in 2009 [1]. In 2015, ATA released the first revised version of these guidelines [2], in order to assist clinicians of all specialties in the management of these patients.The ATA Board of Directors selected the Task Force members for elaborating these revised guidelines based on published scientific data in the management of MTC, and included international scientists from the fields of endocrinology, ethics, genetics, medical oncology, molecular biology, nuclear medicine, pathology, paediatrics, radiation oncology, and surgery [2]. Task Force members reviewed relevant articles on MTC by searching MEDLINE/PubMed from January 1980 to April 2014 using specific MTC-related search terms. Task Force members also provided additional relevant articles, book chapters, and other materials. Recommendations were graded using criteria adapted from the United States Preventive Services Task Force Agency for Healthcare Research and Quality as were used in the previous MTC guidelines [1,2]. After revisions and critical reviews of a series of drafts, the Task Force developed a final document, and the ATA Board of Directors approved the revised set of guidelines [2].Compared to the earlier version [1], the 2015 revised ATA guidelines on the management of patients with MTC (now consisting of 67 recommendations and related explanatory * Giorgio Treglia giorgiomednuc@libero.it on behalf of the EANM and the EANM Thyroid Committee

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Clinical Relevance of ¹⁸F-FDG PET and ¹⁸F-DOPA PET in Recurrent Medullary Thyroid Carcinoma

Cited by 86 publications

References 29 publications

Diagnostic accuracy of [18F]DOPA PET and PET/CT in patients with neuroendocrine tumors: a meta-analysis

Diagnostic accuracy of [18F]DOPA PET and PET/CT in patients with neuroendocrine tumors: a meta-analysis

Immuno-PET Using Anticarcinoembryonic Antigen Bispecific Antibody and ⁶⁸Ga-Labeled Peptide in Metastatic Medullary Thyroid Carcinoma: Clinical Optimization of the Pretargeting Parameters in a First-in-Human Trial

The 2015 Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma: the “evidence-based” refusal to endorse them by EANM due to the “not evidence-based” marginalization of the role of Nuclear Medicine

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Clinical Relevance of 18F-FDG PET and 18F-DOPA PET in Recurrent Medullary Thyroid Carcinoma

Cited by 86 publications

References 29 publications

Diagnostic accuracy of [18F]DOPA PET and PET/CT in patients with neuroendocrine tumors: a meta-analysis

Diagnostic accuracy of [18F]DOPA PET and PET/CT in patients with neuroendocrine tumors: a meta-analysis

Immuno-PET Using Anticarcinoembryonic Antigen Bispecific Antibody and 68Ga-Labeled Peptide in Metastatic Medullary Thyroid Carcinoma: Clinical Optimization of the Pretargeting Parameters in a First-in-Human Trial

The 2015 Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma: the “evidence-based” refusal to endorse them by EANM due to the “not evidence-based” marginalization of the role of Nuclear Medicine

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Clinical Relevance of ¹⁸F-FDG PET and ¹⁸F-DOPA PET in Recurrent Medullary Thyroid Carcinoma

Immuno-PET Using Anticarcinoembryonic Antigen Bispecific Antibody and ⁶⁸Ga-Labeled Peptide in Metastatic Medullary Thyroid Carcinoma: Clinical Optimization of the Pretargeting Parameters in a First-in-Human Trial