Evaluation of F-18 DOPA PET/CT in the detection of recurrent or metastatic medullary thyroid carcinoma: comparison with GA-68 DOTA-TATE PET/CT

Asa, Sertaç; Sönmezoğlu, Kerim; Uslu-Beşli, Lebriz; Şahin, Onur Erdem; Karayel, Emre; Pehlivanoğlu, Hüseyin; Sağer, Sait; Kabasakal, Levent; Ocak, Meltem; Sayman, Haluk

doi:10.1007/s12149-021-01627-2

Cited by 21 publications

(17 citation statements)

References 37 publications

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“…68Ga-SSA, and in particular 68Ga-DOTA-TATE (DOTA-Tyr3-octreotate), is applicable in the diagnosis of MTC bone metastases. Here, DOTA-Tyr3-octreotate has shown better results than 18F-FDOPA and similar results to MRI [ 56 , 57 , 58 ].…”

Section: Introductionmentioning

confidence: 55%

Update on the Diagnosis and Management of Medullary Thyroid Cancer: What Has Changed in Recent Years?

Kaliszewski

Ludwig

et al. 2022

Cancers

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Medullary thyroid carcinoma (MTC) is a neoplasm originating from parafollicular C cells. MTC is a rare disease, but its prognosis is less favorable than that of well-differentiated thyroid cancers. To improve the prognosis of patients with MTC, early diagnosis and prompt therapeutic management are crucial. In the following paper, recent advances in laboratory and imaging diagnostics and also pharmacological and surgical therapies of MTC are discussed. Currently, a thriving direction of development for laboratory diagnostics is immunohistochemistry. The primary imaging modality in the diagnosis of MTC is the ultrasound, but opportunities for development are seen primarily in nuclear medicine techniques. Surgical management is the primary method of treating MTCs. There are numerous publications concerning the stratification of particular lymph node compartments for removal. With the introduction of more effective methods of intraoperative parathyroid identification, the complication rate of surgical treatment may be reduced. The currently used pharmacotherapy is characterized by high toxicity. Moreover, the main limitation of current pharmacotherapy is the development of drug resistance. Currently, there is ongoing research on the use of tyrosine kinase inhibitors (TKIs), highly specific RET inhibitors, radiotherapy and immunotherapy. These new therapies may improve the prognosis of patients with MTCs.

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Section: Introductionmentioning

confidence: 55%

Update on the Diagnosis and Management of Medullary Thyroid Cancer: What Has Changed in Recent Years?

Kaliszewski

Ludwig

et al. 2022

Cancers

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“…[ 68 Ga]-DOTATOC/-TATE was investigated in the present analysis, as this is a routinely available radiotracer at our institution. Although [ 18 F]-dihydroxyphenylalanine ([ 18 F]-DOPA) has been reported to be superior relative to [ 68 Ga]-DOTATOC or –TATE for imaging of MTC patients in selected clinical scenarios [ 18 ], the latter PET agents are more widely available due to an increased use for gastrointestinal neuroendocrine tumors [ 19 ], thereby rendering our findings more relevant for a broader community. PET-based quantification was also conducted by manually segmenting sites of disease using a dedicated software package (syngo.via, Siemens Healthineers, Erlangen, Germany), providing averaged peak standardized uptake value (SUV peak ) and tumor volume (TV) from PET.…”

Section: Methodsmentioning

confidence: 99%

Somatostatin receptor-directed molecular imaging for therapeutic decision-making in patients with medullary thyroid carcinoma

et al. 2022

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Background Somatostatin receptor (SSTR) positron emission tomography/computed tomography (PET/CT) is increasingly deployed in the diagnostic algorithm of patients affected with medullary thyroid carcinoma (MTC). We aimed to assess the role of SSTR-PET/CT for therapeutic decision making upon restaging. Methods 23 pretreated MTC patients underwent SSTR-PET/CT and were discussed in our interdisciplinary tumor board. Treatment plans were initiated based on scan results. By comparing the therapeutic regimen before and after the scan, we assessed the impact of molecular imaging on therapy decision. SSTR-PET was also compared to CT portion of the SSTR-PET/CT (as part of hybrid imaging). Results SSTR-PET/CT was superior in 9/23 (39.1%) subjects when compared to conventional CT and equivalent in 14/23 (60.9%). Those findings were further corroborated on a lesion-based level with 27/73 (37%) metastases identified only by functional imaging (equivalent to CT in the remaining 46/73 (63%)). Investigating therapeutic decision making, no change in treatment was initiated after PET/CT in 7/23 (30.4%) patients (tyrosine kinase inhibitor (TKI), 4/7 (57.2%); surveillance, 3/7 (42.8%)). Imaging altered therapy in the remaining 16/23 (69.6%). Treatment prior to PET/CT included surgery in 6/16 (37.5%) cases, followed by TKI in 4/16 (25%), active surveillance in 4/16 (25%), and radiation therapy (RTx) in 2/16 (12.5%) subjects. After SSTR-PET/CT, the therapeutic regimen was changed as follows: In the surgery group, 4/6 (66.7%) patients underwent additional surgery, and 1/6 (16.7%) underwent surveillance and TKI, respectively. In the TKI group, 3/4 (75%) individuals received another TKI and the remaining subject (1/4, 25%) underwent peptide receptor radionuclide therapy. In the surveillance group, 3/4 (75%) underwent surgery (1/4, (25%), RTx). In the RTx group, one patient was switched to TKI and another individual was actively monitored (1/2, 50%, respectively). Moreover, in the 16 patients in whom treatment was changed by molecular imaging, control disease rate was achieved in 12/16 (75%) during follow-up. Conclusions In patients with MTC, SSTR-PET/CT was superior to CT alone and provided relevant support in therapeutic decision-making in more than two thirds of cases, with most patients being switched to surgical interventions or systemic treatment with TKI. As such, SSTR-PET/CT can guide the referring treating physician towards disease-directed treatment in various clinical scenarios.

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“…Patient-based DRs of [ 18 F]FDOPA PET/CT, [ 18 F]FDG PET/CT, whole-body MRI, and whole-body CT were 64%, 40%, 40%, and 48%, respectively, demonstrating superior sensitivity of [ 18 F]FDOPA PET/CT in localization of the recurrent and persistent disease. Asa et al in a recent comparative study that enrolled 46 MTC patients with elevated calcitonin and/or CEA serum levels, evaluated the performance of [ 18 F]FDOPA PET/CT and [ 68 Ga]Ga-DOTA-TATE in the detection of recurrent or metastatic MTC [ 124 ]. [ 18 F]FDOPA PET/CT demonstrated sensitivity, specificity, positive predictive value (PPV), NPV, and accuracy of 86.8%, 100%, 100%, 61.5%, and 89.1%, respectively, while [ 68 Ga]Ga-DOTA-TATE PET/CT had a similar performance characteristics of 84.2%, 87.5%, 96.9%, 53.8%, and 84.6%, respectively.…”

Section: Medullary Thyroid Cancermentioning

confidence: 99%

Molecular Imaging and Theragnostics of Thyroid Cancers

Giovanella

Deandreis

Vrachims³

et al. 2022

Cancers

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Molecular imaging plays an important role in the evaluation and management of different thyroid cancer histotypes. The existing risk stratification models can be refined, by incorporation of tumor-specific molecular markers that have theranostic power, to optimize patient-specific (individualized) treatment decisions. Molecular imaging with varying radioisotopes of iodine (i.e., 131I, 123I, 124I) is an indispensable component of dynamic and theragnostic risk stratification of differentiated carcinoma (DTC) while [18F]F-fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) helps in addressing disease aggressiveness, detects distant metastases, and risk-stratifies patients with radioiodine-refractory DTC, poorly differentiated and anaplastic thyroid cancers. For medullary thyroid cancer (MTC), a neuroendocrine tumor derived from thyroid C-cells, [18F]F-dihydroxyphenylalanine (6-[18F]FDOPA) PET/CT and/or [18F]FDG PET/CT can be used dependent on serum markers levels and kinetics. In addition to radioiodine therapy for DTC, some theragnostic approaches are promising for metastatic MTC as well. Moreover, new redifferentiation strategies are now available to restore uptake in radioiodine-refractory DTC while new theragnostic approaches showed promising preliminary results for advanced and aggressive forms of follicular-cell derived thyroid cancers (i.e., peptide receptor radiotherapy). In order to help clinicians put the role of molecular imaging into perspective, the appropriate role and emerging opportunities for molecular imaging and theragnostics in thyroid cancer are discussed in our present review.

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Evaluation of F-18 DOPA PET/CT in the detection of recurrent or metastatic medullary thyroid carcinoma: comparison with GA-68 DOTA-TATE PET/CT

Cited by 21 publications

References 37 publications

Update on the Diagnosis and Management of Medullary Thyroid Cancer: What Has Changed in Recent Years?

Update on the Diagnosis and Management of Medullary Thyroid Cancer: What Has Changed in Recent Years?

Somatostatin receptor-directed molecular imaging for therapeutic decision-making in patients with medullary thyroid carcinoma

Molecular Imaging and Theragnostics of Thyroid Cancers

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