Positron Emission Tomography Radiopharmaceuticals in Differentiated Thyroid Cancer

Abstract

Differentiated thyroid cancer (DTC), arising from thyroid follicular epithelial cells, is the most common type of thyroid cancer. Despite the well-known utilization of radioiodine treatment in DTC, i.e., iodine-131, radioiodine imaging in DTC is typically performed with iodine-123 and iodine-131, with the current hybrid scanner performing single photon emission tomography/computed tomography (SPECT/CT). Positron emission tomography/computed tomography (PET/CT) provides superior visualization and quantification of functions at the molecular level; thus, lesion assessment can be improved compared to that of SPECT/CT. Various types of cancer, including radioiodine-refractory DTC, can be detected by 2-[18F]fluoro-2-deoxy-D-glucose ([18F]FDG), the most well-known and widely used PET radiopharmaceutical. Several other PET radiopharmaceuticals have been developed, although some are limited in availability despite their potential clinical utilizations. This article aims to summarize PET radiopharmaceuticals in DTC, focusing on molecular pathways and applications.

2-Deoxy-D-Glucose: A Novel Pharmacological Agent for Killing Hypoxic Tumor Cells, Oxygen Dependence-Lowering in Covid-19, and Other Pharmacological Activities

“…18F-fuoro-2-deoxy-D-glucose has been used in positron emission tomography (FDG-PET) with computed tomography (CT) for lymph node (LN) staging in urothelial carcinoma (UC) [135], follicular lymphoma [136], polymyalgia rheumatica [137], thyroid nodules [138], and detection of bone marrow metastases [139,140].…”

Molecular Theranostics in Radioiodine-Refractory Differentiated Thyroid Cancer

“…Additionally, patients with Cancer cells have a higher concentration of membranous GLUT proteins, such as GLUT1 and GLUT3, and more enzymes involved in the glycolytic pathway, which is even more pronounced in undifferentiated cancer cells. Therefore [ 18 F]FDG is more intensely accumulated in cancer cells as compared to normal cells [17]. In undifferentiated DTC cells, iodine accumulation is decreased or lost, but GLUT proteins are upregulated, and consequently, [ 18 F]FDG uptake is higher [18].…”

“…Fibroblast activation protein (FAP) expression is very low in normal human fibroblasts. However, cancer-related fibroblasts are characterized by high expression of FAP (Figure 1) since they carry both exopeptidase and endopeptidase activity [17]. A large fraction of the total mass in various tumors is made of tumor fibroblasts and extracellular fibrosis, while on many occasions less than 10% of tumor cells are involved [55].…”

Importancia del manejo multidisciplinario en el paciente con cáncer de tiroides diferenciado

“…Estas dan lugar al DTC (papilar y folicular) y al cáncer anaplásico de tiroides. El segundo tipo de células son las parafoliculares o C, las cuales producen la hormona calcitonina y dan origen al DTC medula (Delcorte O et al, 2022& Sakulpisuti C. et al 2022 En 2022, la European Thyroiud Journal postula que existen dos tipos principales de DTC: papilar y folicular. El cáncer de tiroides papilar es el tipo más común de DTC y representa el 80-90 % de todos los cánceres de tiroides.…”