Retrospective analysis of PSMA PET/CT thyroid incidental uptake in adults: incidence, diagnosis, and treatment/outcome in a tertiary cancer referral center and University Medical Center

Piek, Marceline W; Vries, Lisa H. de; Donswijk, Maarten L.; Keizer, Bart de; Boer, Jan Paul de; Lodewijk, Lutske; Leeuwaarde, Rachel S van; Vriens, Menno R.; Hartemink, Koen J.; Ploeg, Iris M. C. van der

doi:10.1007/s00259-022-05679-y

Cited by 9 publications

(5 citation statements)

References 47 publications

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“…Studies have shown elevated PSMA expression in primary thyroid carcinomas in contrast to benign etiologies 30 , 33 , 34 . Increased PSMA avidity has also been observed in metastases from other solid malignancies, including renal cell carcinoma and lung adenocarcinoma 30 , 31 , 35 . Given the potential association with malignancy, the identification of an incidental PSMA-avid thyroid gland lesion should prompt further investigation.…”

Section: Discussionmentioning

confidence: 93%

“…The significance of PSMA uptake using 18F labeled PSMA agents, including 18F-DCFPyL, in thyroid gland incidentalomas is largely still emerging, particularly as PSMA is now known to be expressed in a number of non-prostate tissues, both malignant and benign 19 . A recent retrospective cohort found (Ga-PSMA-11, 18F-PSMA, or 18F-DCFPyL) PSMA-avid thyroid gland lesions in 1.1% of patients undergoing PSMA PET evaluation for PCa; of these, a small but clinically significant proportion (3 of 61) were malignant, with one differentiated thyroid carcinoma, one Hürthle cell carcinoma and one renal cell carcinoma metastasis 31 . A similar pattern was seen in a second meta-analysis of PSMA-avid incidentalomas; of the 23 lesions identified, 5 represented primary thyroid cancer while a sixth was a metastasis from renal cell carcinoma 32 .…”

Section: Discussionmentioning

confidence: 99%

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Use of PSMA PET/CT to detect prostate cancer metastatic to a preexisting thyroid nodule

Chalker,

Yilmaz,

Trone

et al. 2024

npj Precis. Onc.

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Prostate cancer (PCa) seldom metastasizes to the thyroid gland, and only a limited number of cases are documented in the literature. The application of a relatively recent and highly sensitive imaging technique, prostate-specific membrane antigen (PSMA) positron emission tomography—computed tomography (PET/CT), has enhanced the identification of metastatic disease. Nevertheless, as PSMA is expressed in various tissue types, the clinical importance of a PSMA-avid thyroid lesion remains largely uncertain. A minor, yet noteworthy, percentage of these lesions are ultimately determined to be malignant. Here we describe the case of a 70-year-old man with a past medical history of Lynch syndrome who presented to an outpatient oncologic clinic for management of very high risk localized PCa. He developed metastatic recurrence and his disease progressed through several lines of therapy, including immunotherapy and targeted treatments. He was found to have a new, intense PSMA uptake in an existing, previously benign thyroid nodule. Sonographic evaluation revealed changing morphology despite grossly stable size. Repeat biopsy confirmed the unusual finding of PCa metastasis to a known thyroid nodule. The shift in PSMA avidity played a pivotal role in discerning this metastatic deposit. There is a potential risk that such lesions may be inadequately acknowledged. The impact of the patient’s Lynch syndrome on this presentation remains uncertain.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Use of PSMA PET/CT to detect prostate cancer metastatic to a preexisting thyroid nodule

Chalker,

Yilmaz,

Trone

et al. 2024

npj Precis. Onc.

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“…Moreover, PSMA-based imaging modalities may provide the opportunity to acquire more information for patients planning active surveillance because preoperative PSMA-based imaging findings are expected to predict the recurrence after initial management. Although PSMA expression was easily acquired using immunohistochemical staining, it was not specific to thyroid carcinoma [ 36 ]. Careful selection for PSMA-based imaging is required during the initial phase of PTC.…”

Section: Discussionmentioning

confidence: 99%

Prostate-specific membrane antigen expression predicts recurrence of papillary thyroid carcinoma after total thyroidectomy

Ryu

Lim

et al. 2022

BMC Cancer

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Background Prostate-specific membrane antigen (PSMA) overexpression has been observed in the endothelial neovasculature of several solid malignancies. This study aimed to identify PSMA expression in the primary tumor of classical papillary thyroid carcinoma (PTC) and assess the correlation between the degree of PSMA expression and recurrence. Methods We reviewed the electronic medical records of patients who underwent total thyroidectomy and central neck dissection, with or without lateral neck dissection, for classical PTC between 2009 and 2014 at our institution. Recurrence was defined as a structural disease based on histological confirmation on follow-up. Fifty-one patients with the recurrent structural disease were matched, using a propensity score matching method, to patients with no disease evidence during follow-up. Clinicopathological and follow-up data were collected for 102 patients. The monoclonal mouse anti-human PSMA/FOLH1/NAALADase I antibody was used for staining the primary tumor. The score of PSMA expression was classified as negative (< 5% positivity), weak (5–10 % positivity), moderate (11–49% positivity), and strong (more than 50% positivity). Clinicopathological factors were compared between patients with low and high PSMA expression. Moreover, whether the degree of PSMA expression and clinicopathological factors could predict recurrence was investigated. Cox proportional hazard regression models were used to evaluate the risk of recurrence. Results There was no significant difference in clinicopathological factors between low (negative or weak) and high (moderate or strong) PSMA expression. Gross extrathyroidal extension (ETE), absence of chronic lymphocytic thyroiditis, and high PSMA expression were all associated with lower recurrence-free survival (RFS) rate in a univariate analysis. In multivariate analysis, gross ETE (hazard ratio [HR], 2.279; 95% confidence interval [CI], 1.257−4.132; p = 0.007) and high PSMA expression (HR, 1.895; 95% CI, 1.073−3.348; p = 0.028) were associated with poor RFS. Conclusions High PSMA expression in the primary tumor was a significant factor in predicting recurrence in classic PTC. PSMA could be a potential biomarker for personalized management for PTC.

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“…В течение последних 2 лет в зарубежной литературе опубликован ряд работ, в которых представлены возможности проведения пептидно-рецепторной радионуклидной терапии с использованием радиоактивно меченных аналогов соматостатина ( 177 Lu-DOTA-TATE), продемонстрирована перспективность в лечении радиойодрефрактерного ДРЩЖ с объективной частотой ответа в виде уменьшения опухоли на 20-60 % по критериям Response evaluation criteria in solid tumours 1.1 (RECIST 1.1) [68][69][70]. В то же время некоторые пилотные исследования показали повышенную экспрессию PSMA-рецепторов у больных радиойодрефрактерным ДРЩЖ при выполнении ПЭТ-КТ c 18 F-PSMA и 68 Ga-PSMA, что с учетом тераностического принципа делает возможным применение в будущем радиолигандной терапии 177 Lu-DOTA-PSMA-617 у данной категории пациентов [71,72].…”

Section: перспективы пептидно-рецепторной радионуклидной и радиолиган...unclassified

Follow-up after radioiodine remnant ablation in differentiated thyroid cancer: the view of nuclear medicine physician

Shurinov

Бородавина

2023

Opuholi golovy i šei

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Timeliness of accurate dynamic observation and a clear understanding of the treatment response guarantees health of patients with differentiated thyroid cancer. Multidimensional approach to evaluation of thyroid-stimulating hormone, tumor markers, ultrasound picture, as well as results of molecular imaging with radioactive iodine is clearly defined in international clinical guidelines. At the A.F. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Center for more than 15 years tactics of control exam 6 months after radioactive iodine ablation has been implemented. The aim of the current article is to consider the sequence of diagnostic search for different responses to treatment of differentiated thyroid cancer.

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Retrospective analysis of PSMA PET/CT thyroid incidental uptake in adults: incidence, diagnosis, and treatment/outcome in a tertiary cancer referral center and University Medical Center

Cited by 9 publications

References 47 publications

Use of PSMA PET/CT to detect prostate cancer metastatic to a preexisting thyroid nodule

Use of PSMA PET/CT to detect prostate cancer metastatic to a preexisting thyroid nodule

Prostate-specific membrane antigen expression predicts recurrence of papillary thyroid carcinoma after total thyroidectomy

Follow-up after radioiodine remnant ablation in differentiated thyroid cancer: the view of nuclear medicine physician

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