Relative Quantification of Indium-111 Pentetreotide and Gallium-68 DOTATOC Uptake in the Thyroid Gland and Association with Thyroid Pathologies

Abstract

The increased In-111 pentetreotide and Ga-68 DOTATOC uptake in active Hashimoto's disease is most likely related to the lymphocytic infiltration of the thyroid. However, the physiologic or pathophysiologic relevance of the increased In-111 pentetreotide and Ga-68 DOTATOC uptake in normal thyroid glands, hot and cold nodules, and goiters and nodular thyroids remain to be determined.

Jak często wykrywamy przypadkowe zmiany w tarczycy w badaniu PET/CT z 68Ga-DOTATATE u pacjentów diagnozowanych z powodu nowotworu neuroendokrynnego?

“…Both studies suggest that increased 68 Ga-labelled SST analogues uptake in thyroid in patients with AITD might be related to the activity of autoimmune disease. Intense tracer uptake was found in some cases (4.8%) of structurally and functionally normal thyroid lobes, but follow-up after 6-14 months did not show any thyroid pathology [20].…”

“…Subsequent biopsy recommended after 68 Ga-DOTATATE PET/CT critically changed in the management of this patients. Interestingly, in published studies the focal pattern was associated mainly with hot thyroid nodule (in 99m Tc) and less frequently with benign cold nodules [19,20]. Due to the high expression of SSTR2 reported in papillary thyroid cancer and benign thyroid nodules in vitro and in vivo studies is probable that the high value of SUVmax could be seen in both conditions [5,6,19,20].…”

“…Data in the literature regarding SSTR2 expression in vivo in benign thyroid pathologies are still limited with a very small sample size [14][15][16][17][18][19][20].…”

“…The radiotracer uptake seen in thyroid can reflect a dense infiltration of lymphocytes that express SSTR2 on their plasma membrane [16,17,19,20].…”

“…Interestingly, in published studies the focal pattern was associated mainly with hot thyroid nodule (in 99m Tc) and less frequently with benign cold nodules [19,20]. Due to the high expression of SSTR2 reported in papillary thyroid cancer and benign thyroid nodules in vitro and in vivo studies is probable that the high value of SUVmax could be seen in both conditions [5,6,19,20]. Therefore, in the case of focal uptake of 68 Ga-DOTATATE, the patient should undergo further examination, including ultrasonography and FNA, to exclude a thyroid carcinoma.…”