Detection of Occult Medullary Thyroid Cancer Recurrence with 2-Deoxy-2-[F-18]fluoro-d-glucose-PET and PET/CT

Abstract

Our findings suggest a significant role for FDG-PET in patients with suspected MTC recurrence, with sensitivity of 85.7% and specificity of 83.3% for disease detection. FDG-PET provides additional information in a significant fraction of cases (54%) and could be used for restaging of patients with MTC and elevated levels of biomarkers (calcitonin). Additional studies are necessary to further evaluate the role of FDG-PET in MTC.

Comparison of 18F-DOPA, 18F-FDG and 68Ga-somatostatin analogue PET/CT in patients with recurrent medullary thyroid carcinoma

“…A possible explanation for this low 18 F-FDG PET/CT sensitivity (17%) in our series when compared to those reported in the literature (30-95%) could be related to the significant number of MTC [8,9,11,[13][14][15][23][24][25][26][27][28][29][30][31][32][33]. Nevertheless, 18 F-FDG PET/CT may provide useful information in patients with more aggressive disease, as demonstrated in patient 4 in whom it detected multiple liver lesions that were missed on functional PET/CT with the other two tracers, as well as two additional locoregional lymph nodes.…”

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

“…Reports have confirmed the use of 18 F-FDG PET and PET/CT for restaging MTC to detect tumor recurrence with patient-based sensitivities that range from 47 to 79% and lesion-based sensitivities that range from 76 to 96% [16][17][18]23,[44][45][46][47][48][49][50][51][52][53]. Reported patient-based sensitivity ranges between 47 and 79% with higher lesion-based sensitivity between 76 and 96%.…”

“…In an early multicenter trial of 85 patients with histopathological confirmation, 18 F-FDG PET exhibited a lesion-based sensitivity of 78% and specificity of 79%, whereas other imaging modalities -CT 50%, MRI 82%, SRS 25%, DMSA(V) 33%, and sestamibi 24% -were less successful [23]. However, in subsequent studies the sensitivity of 18 F-FDG PET for MTC fell to 40-60%, particularly when the value of Ct was less than 1000 pg/ml [16][17][18]45,[47][48][49][50][51][52][53]. Comparative studies of 18 F-FDG PET versus CT and MRI have reported a lower sensitivity for 18 F-FDG PET [49,50].…”

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

“…PET using the radioactive tracers 18 F-FDG and more recently 18 F-dihydroxyphenylanaline ( 18 F-DOPA) are available for the staging and follow-up of MTC (9)(10)(11)(12)(13)(14)(15). Some studies have suggested that 18 F-FDG PET might be more sensitive in patients with a short calcitonin doubling time (16,17).…”