New Radionuclide Tracers for the Diagnosis and Therapy of Medullary Thyroid Carcinoma

Hoefnagel, C.A.; Delprat, C.C.; Zanin, D. E. A.; Schoot, J. B. van der

doi:10.1097/00003072-198803000-00003

Cited by 58 publications

(17 citation statements)

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“…In the last years, new functional imaging techniques based on the clinical application of different radiopharmaceuticals, have been tested in MTC patients raising each time enthusiastic initial results (Ohta et al 1984, Hoefnagel et al 1988, Guerra et al 1989, Troncone et al 1989. However, for the most, initial results have not been confirmed by subsequent studies.…”

Section: Discussionmentioning

confidence: 99%

Secretive and proliferative tumor profile helps to select the best imaging technique to identify postoperative persistent or relapsing medullary thyroid cancer

Faggiano¹,

Grimaldi²,

Pezzullo³

et al. 2009

Endocrine-Related Cancer

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In patients with postoperative persistent medullary thyroid cancer (MTC), the tumor detection rate is generally low for most of the imaging techniques now available. The aim of this study was to investigate if the clinico-biological profile of the tumor may indicate which imaging technique to perform in order to identify postoperative persistent or relapsing MTC foci. Thirty-five consecutive MTC patients with detectable and progressively increasing postoperative serum concentrations of calcitonin were enrolled in the study. The detection rates of 18F-deoxy-D-glucose (FDG)-positron emission tomography (PET), somatostatin receptor scintigraphy (SRS), and 131I-metaiodobenzylguanidine scintigraphy (MIBG) were compared in relation with calcitonin and carcinoembryonic antigen serum concentrations, Ki-67 score and results of conventional imaging techniques (CIT). FDG-PET positivity was significantly associated with calcitonin serum concentrations O400 pg/ml and Ki-67 score O2.0% (P!0.05), while SRS positivity was associated with calcitonin serum concentrations O800 pg/ml (P!0.05). SRS positivity significantly correlated with tumor appearance at CIT (P!0.01), while FDG-PET was positive in nine CIT-negative patients. The secretive and proliferative tumor profile may guide the choice of the imaging technique to use in the follow-up of patients with MTC. A Ki-67 score O2.0% suggests to perform a FDG-PET in addition to conventional imaging. Calcitonin secretion predicts both FDG-PET and SRS uptake but SRS positivity is generally found only in patients with well defined MTC lesions that are also detectable at the conventional imaging examination. MIBG outcome is not predicted by any clinico-biological factors here investigated.

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Section: Discussionmentioning

confidence: 99%

Secretive and proliferative tumor profile helps to select the best imaging technique to identify postoperative persistent or relapsing medullary thyroid cancer

Faggiano¹,

Grimaldi²,

Pezzullo³

et al. 2009

Endocrine-Related Cancer

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“…MRI has similar indications and it can also be used in the evaluation of the mediastinum (Crow et al, 1989). Various [99mTc](V)DMSA, 1111231_MIBG and 201T1 show different sensitivities of lesion detection in different reports (Arnstein et al, 1986;Hilditch et al, 1986Hilditch et al, , 1987Baulieu et al, 1987;Clarke et al, 1987Clarke et al, , 1988Hoefnagel et al, 1988;Adams et al, 1990;Guerra et al, 1989;Charkes et al, 1990;Udelsman et al, 1993). These different sensitivities can be related to patient selection, limited number of patients studied, Ct blood levels, dimension of lesions studied or to methodological problems.…”

Section: Resultsmentioning

confidence: 99%

“…Several methods based on tumour avidity of non-specific radiopharmaceuticals such as [99"Tc](V)DMSA, '3I11231-MIBG and 20'T1 have also been designed for this purpose, with variable results (Arnstein et al, 1986;Hilditch et al, 1986;Baulieu et al, 1987;Clarke et al, 1987;Hilditch, 1987; Clarke et al, 1988;Hoefnagel et al, 1988;Guerra et al, 1989;Adams et al, 1990;Charkes et al, 1990;Udelsman et al, 1993).…”

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confidence: 99%

Pretargeted immunoscintigraphy in patients with medullary thyroid carcinoma

Magnani

Paganelli²,

Songini³

et al. 1996

Br J Cancer

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Summary To evaluate the use of pretargeted immunoscintigraphy (ISG) in the diagnosis and follow-up of patients with medullary thyroid carcinoma (MTC), we studied 25 patients with histologically proven disease; ISG was repeated after surgery in two patients. The antibody, either an anticarcinoembryonic antigen (CEA) or an antichromogranin A (CgA) biotinylated monoclonal antibody (MAb) or a cocktail of the two biotinylated MAbs was first injected. After 24 h, avidin was administrated i.v., followed by "'In-labelled biotin 24 h later. Fifty-two lesions were visualised. Six primary tumours, diagnosed by increased calcitonin levels, were all correctly diagnosed; 47 recurrences, also suspected by blood tumour markers, were detected and confirmed by cytology or histology. In one case, single photon emission tomography allowed the detection of small lymph nodes with a diameter of 4 -7 mm. These lesions, not judged neoplastic by ultrasound, were confirmed to be neoplastic by fine needle aspiration. Pretargeted ISG correctly localises primary tumours and recurrences in MTC patients, when the only marker of relapse is serum elevation of calcitonin. With this three-step pretargeting method, cocktails of potentially useful MAbs can be used, avoiding false-negative studies that may occur when CEA or CgA are not expressed.Keywords: medullary thyroid carcinoma; monoclonal antibody; avidin-biotin Medullary thyroid carcinoma (MTC) arises from calcitoninsecreting parafollicular cells in the thyroid. Both the sporadic and the familial form are treated by surgery (Chong et al., 1975;Rossi et al., 1980), as the efficacy of radiotherapy is limited (Samaan et al., 1988) and chemotherapy is ineffective (Rougier et al., 1983;Brunt and Wells, 1987). Early diagnosis of recurrence or metastasis and accurate localisation of recurrent disease are very important prerequisites for successful surgical excision.Elevated serum calcitonin (Ct) is considered to be a marker for MTC. High serum levels of Ct and carcinoembryonic antigen (CEA) can often be found in patients with recurrent disease several years before it becomes clinically apparent, but, at present, no efficient and specific method is available for the localisation of recurrences.Morphological imaging techniques (ultrasonography, US; computerised tomography, CT; magnetic resonance imaging, MRI) are routinely used to confirm and localise a biologically detected recurrence but are not always adequate because of topographic polymorphism and the small size of tumour recurrences at an early stage of development (Schwerk et al., 1985;Frank et al., 1987;Crow et al., 1989).Several methods based on tumour avidity of non-specific radiopharmaceuticals such as [99"Tc](V)DMSA, '3I11231-MIBG and 20'T1 have also been designed for this purpose, with variable results (Arnstein et al., 1986;Hilditch et al., 1986;Baulieu et al., 1987;Clarke et al., 1987;Hilditch, 1987; Clarke et al., 1988;Hoefnagel et al., 1988;Guerra et al., 1989;Adams et al., 1990;Charkes et al., 1990;Udelsman et al., 1993).In the attem...

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“…Ultraschalluntersuchung, Computertomographie und selektive Vencnkatheterisierung werden als wichtigste diagnostische Maßnahmen angesehen [11], Auch Isotopendiagnostik wurde mit unterschiedlicher Sensitivität [1] beim medullären Schilddrüsenkarzinom einge setzt. Das Guanethidin-Analog 12'Jod-MIBG, das in der Dia gnostik und Therapie des Phäochromozytoms eingesetzt wird, kann auch von primären oder metastasierenden medullären Schilddrüsenkarzinomen aufgenommen werden [8,16], Im Vergleich zum Tc-99m-DMSA-Szintigramm und dem Tc-99m-MDP-Knochenszintigramm ist die Sensitivität jedoch gering [7], Bei unserem Patienten führten nuklearmedizinische Un tersuchungen nicht zur Erkennung des metastatischen Kno chenbefalls. Auch die Immunszintigraphie mit CEA-Antikör-pern, die beim metastasierenden C-Zellkarzinom empfohlen wurde [1,3], half nicht weiter.…”

Section: Diskussionunclassified

Metastasierendes C-Zellkarzinom mit Knochenmarkkarzinose bei multipler endokriner Neoplasie (MEN) Typ IIa

Me¹,

Hastka²,

Queißer³

1990

Oncol Res Treat

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Es wird der Verlauf eines Patienten mit multipler endokriner Neoplasie Typ II a Über sieben Jahre beschrieben. Trotz ausgedehnter diagnostischer Untersuchungen gelang es erst durch eine Knochenstanzbiopsie, die Metastasierung zu sichern. Alle therapeutischen Maßnahmen wie Kombinationschemotherapie, Sandostatin, Bromocriptin und ¹³¹Jod-Methylendiphosphonat-Therapie erwiesen sich als wenig wirksam in bezug auf Tumorreduktion oder VermÍnderung der Symptomatik.

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New Radionuclide Tracers for the Diagnosis and Therapy of Medullary Thyroid Carcinoma

Cited by 58 publications

References 0 publications

Secretive and proliferative tumor profile helps to select the best imaging technique to identify postoperative persistent or relapsing medullary thyroid cancer

Secretive and proliferative tumor profile helps to select the best imaging technique to identify postoperative persistent or relapsing medullary thyroid cancer

Pretargeted immunoscintigraphy in patients with medullary thyroid carcinoma

Metastasierendes C-Zellkarzinom mit Knochenmarkkarzinose bei multipler endokriner Neoplasie (MEN) Typ IIa

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