SPECT/CT and PET/CT molecular imaging in medullary thyroid carcinoma. Are we running in the right direction?

Maffione, Anna Margherita; Giammarile, Francesco; Rubello, Domenico

doi:10.1007/s00259-017-3757-6

Cited by 3 publications

(2 citation statements)

References 18 publications

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“…5,35,36 Comparative analyses between 18 F-DOPA and 18 F-FDG have shown better results with 18 F-DOPA in terms of sensitivity and specificity and a complementary role of the two radiopharmaceuticals in the assessment of recurrent MTC. 5,25,37,38 The different behaviour of 18 F-DOPA and 18 F-FDG in recurrent MTC can be explained by their different uptake mechanisms that, in turn, reflect the different metabolic pathways of NET cells, including MTC cells.…”

Section: -34mentioning

confidence: 99%

Detection rate of somatostatin receptor PET in patients with recurrent medullary thyroid carcinoma: a systematic review and a meta-analysis

Treglia

Tamburello

Giovanella

2018

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Section: -34mentioning

confidence: 99%

Detection rate of somatostatin receptor PET in patients with recurrent medullary thyroid carcinoma: a systematic review and a meta-analysis

Treglia

Tamburello

Giovanella

2018

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“…Similar to image-based diagnostics, the therapeutic armamentarium for recurrent disease has also been further expanded from external beam radiation (RTx) or active surveillance to novel systemic treatment options, including tyrosine kinase inhibitors (TKI), pasireotide combined with everolimus or peptide receptor radionuclide therapy (PRRT) [1,[11][12][13][14]. As such, given the increasing use of SSTRtargeted imaging for MTC [4,13,15,16], we aimed to assess the role of this functional imaging modality as a therapeutic decision aid in a real-world scenario.…”

Section: Introductionmentioning

confidence: 99%

Somatostatin receptor-directed molecular imaging for therapeutic decision-making in patients with medullary thyroid carcinoma

et al. 2022

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Background Somatostatin receptor (SSTR) positron emission tomography/computed tomography (PET/CT) is increasingly deployed in the diagnostic algorithm of patients affected with medullary thyroid carcinoma (MTC). We aimed to assess the role of SSTR-PET/CT for therapeutic decision making upon restaging. Methods 23 pretreated MTC patients underwent SSTR-PET/CT and were discussed in our interdisciplinary tumor board. Treatment plans were initiated based on scan results. By comparing the therapeutic regimen before and after the scan, we assessed the impact of molecular imaging on therapy decision. SSTR-PET was also compared to CT portion of the SSTR-PET/CT (as part of hybrid imaging). Results SSTR-PET/CT was superior in 9/23 (39.1%) subjects when compared to conventional CT and equivalent in 14/23 (60.9%). Those findings were further corroborated on a lesion-based level with 27/73 (37%) metastases identified only by functional imaging (equivalent to CT in the remaining 46/73 (63%)). Investigating therapeutic decision making, no change in treatment was initiated after PET/CT in 7/23 (30.4%) patients (tyrosine kinase inhibitor (TKI), 4/7 (57.2%); surveillance, 3/7 (42.8%)). Imaging altered therapy in the remaining 16/23 (69.6%). Treatment prior to PET/CT included surgery in 6/16 (37.5%) cases, followed by TKI in 4/16 (25%), active surveillance in 4/16 (25%), and radiation therapy (RTx) in 2/16 (12.5%) subjects. After SSTR-PET/CT, the therapeutic regimen was changed as follows: In the surgery group, 4/6 (66.7%) patients underwent additional surgery, and 1/6 (16.7%) underwent surveillance and TKI, respectively. In the TKI group, 3/4 (75%) individuals received another TKI and the remaining subject (1/4, 25%) underwent peptide receptor radionuclide therapy. In the surveillance group, 3/4 (75%) underwent surgery (1/4, (25%), RTx). In the RTx group, one patient was switched to TKI and another individual was actively monitored (1/2, 50%, respectively). Moreover, in the 16 patients in whom treatment was changed by molecular imaging, control disease rate was achieved in 12/16 (75%) during follow-up. Conclusions In patients with MTC, SSTR-PET/CT was superior to CT alone and provided relevant support in therapeutic decision-making in more than two thirds of cases, with most patients being switched to surgical interventions or systemic treatment with TKI. As such, SSTR-PET/CT can guide the referring treating physician towards disease-directed treatment in various clinical scenarios.

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68Ga-DOTATATE-PET shows promise for diagnosis of recurrent or persistent medullary thyroid cancer: A systematic review

Pajak

Cadili

Nabata

et al. 2022

The American Journal of Surgery

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SPECT/CT and PET/CT molecular imaging in medullary thyroid carcinoma. Are we running in the right direction?

Cited by 3 publications

References 18 publications

Detection rate of somatostatin receptor PET in patients with recurrent medullary thyroid carcinoma: a systematic review and a meta-analysis

Detection rate of somatostatin receptor PET in patients with recurrent medullary thyroid carcinoma: a systematic review and a meta-analysis

Somatostatin receptor-directed molecular imaging for therapeutic decision-making in patients with medullary thyroid carcinoma

68Ga-DOTATATE-PET shows promise for diagnosis of recurrent or persistent medullary thyroid cancer: A systematic review

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