Personalized Diagnosis in Differentiated Thyroid Cancers by Molecular and Functional Imaging Biomarkers: Present and Future

Abstract

Personalized diagnosis can save unnecessary thyroid surgeries, in cases of indeterminate thyroid nodules, when clinicians tend to aggressively treat all these patients. Personalized diagnosis benefits from a combination of imagery and molecular biomarkers, as well as artificial intelligence algorithms, which are used more and more in our timeline. Functional imaging diagnosis such as SPECT, PET, or fused images (SPECT/CT, PET/CT, PET/MRI), is exploited at maximum in thyroid nodules, with a long history in the past and a bright future with many suitable radiotracers that could properly contribute to diagnosing malignancy in thyroid nodules. In this way, patients will be spared surgery complications, and apparently more expensive diagnostic workouts will financially compensate each patient and also the healthcare system. In this review we will summarize essential available diagnostic tools for malignant and benignant thyroid nodules, beginning with functional imaging, molecular analysis, and combinations of these two and other future strategies, including AI or NIS targeted gene therapy for thyroid carcinoma diagnosis and treatment as well.

Assessing Krenning’s score on 68Ga-DOTATATE PET-CT and miPSMA score on 68Ga-PSMA-11 PET-CT in TENIS: a comparison with FDG PET/CT and examining the feasibility of targeted radionuclide therapy

“…Furthermore, abundant PSMA expression in tumor vasculature, with relative sparing of normal tissue, makes it a potential agent for targeted imaging and radionuclide therapy for solid tumors [19]. For patients with RAIR-DTC, 68 Ga-PSMA PET/CT is considered valuable for staging, detecting various lesion types, and potentially identifying lesions not detected by 18 FDG PET/CT [20][21][22]. De Vries et al [22] demonstrated that 68 Ga-PSMA PET/CT may detect more types of lesions than standard imaging methods like 18 FDG-PET/CT, providing valuable insights for managing patients with refractory thyroid cancer.…”

“…Furthermore, abundant PSMA expression in tumor vasculature, with relative sparing of normal tissue, makes it a potential agent for targeted imaging and radionuclide therapy for solid tumors [19]. For patients with RAIR-DTC, 68 Ga-PSMA PET/CT is considered valuable for staging, detecting various lesion types, and potentially identifying lesions not detected by 18 FDG PET/CT [20–22]. De Vries et al .…”