(18)F-DOPA PET/CT in the Diagnosis and Localization of Persistent Medullary Thyroid Carcinoma

Overview

Journal Eur J Nucl Med Mol Imaging

Specialties Biophysics
Nuclear Medicine
Radiology

Date 2015 Oct 27

PMID 26497699

Citations 16

Authors

Aurelien Archier

Celine Heimburger

Carole Guerin

Isabelle Morange

Fausto F Palazzo

Jean-Francois Henry

Olivier Schneegans

Olivier Mundler

Ahmad Esmaeel Abdullah

Frederic Sebag

Alessio Imperiale

David Taieb

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the performance of (18)F-L-dihydroxyphenylalanine ((18)F-DOPA) PET/CT in the detection of locoregional and distant medullary thyroid carcinoma (MTC) metastases and to compare imaging findings with histological data.

Methods: We retrospectively evaluated 86 MTC patients with persistently high serum calcitonin levels after initial surgery who had undergone (18)F-DOPA PET/CT between January 2007 and December 2014 in two referral centres. They were followed up for at least 6 months after the PET/CT assessment. The results were compared with histological data or with the findings obtained during follow-up using a complementary imaging modality.

Results: (18)F-DOPA PET/CT was positive in 65 of the 86 patients, corresponding to a patient-based sensitivity of 75.6 %. Distant metastatic disease (M1) was seen in 29 patients including 11 with previously unknown metastases revealed only by PET/CT. Among the 36 patients without distant metastatic spread, 25 had nodal involvement limited to the neck, and 10 of these 25 patients underwent reoperation. The lymph node compartment-based sensitivity of (18)F-DOPA PET/CT was 100 % in the two institutions but lesion-based sensitivity was only 24 %. Preoperative and postoperative median calcitonin levels were 405 pg/mL (range 128 - 1,960 pg/mL) and 259 pg/mL (range 33 - 1,516 pg/mL), respectively. None of the patients achieved normalization of serum calcitonin after reoperation.

Conclusion: (18)F-DOPA PET/CT enables early diagnosis of a significant number of patients with distant metastasis. It has a limited sensitivity in the detection of residual disease but provides high performance for regional analysis. A surgical compartment-oriented approach could be the approach of choice whatever the number of nodes revealed by (18)F-DOPA PET/CT.

Citing Articles

The role of [18F]F-DOPA PET/CT in diagnostic and prognostic assessment of medullary thyroid cancer: a 15-year experience with 109 patients.

Zhang Z, Yu J, Rainer E, Hargitai L, Jiang Z, Karanikas G Eur Thyroid J. 2024; 13(4).

PMID: 38900599 PMC: 11301540. DOI: 10.1530/ETJ-24-0089.

Sensitivities evaluation of five radiopharmaceuticals in four common medullary thyroid carcinoma metastatic sites on PET/CT: a network meta-analysis and systematic review.

Li P, Zhang Y, Xu T, Zhu J, Wei T, Zhao W Nucl Med Commun. 2023; 44(12):1114-1125.

PMID: 37769014 PMC: 10631508. DOI: 10.1097/MNM.0000000000001773.

Molecular imaging and related therapeutic options for medullary thyroid carcinoma: state of the art and future opportunities.

Imperiale A, Berti V, Burgy M, Cazzato R, Piccardo A, Treglia G Rev Endocr Metab Disord. 2023; 25(1):187-202.

PMID: 37715050 DOI: 10.1007/s11154-023-09836-y.

Prospective study on the clinical relevance of F-DOPA positron emission tomography/computed tomography in patients with medullary thyroid carcinoma.

Califano I, Pitoia F, Chirico R, de Salazar A, Bastianello M Endocrine. 2022; 77(1):143-150.

PMID: 35489000 DOI: 10.1007/s12020-022-03062-3.

Suboptimal accuracy of ultrasound and ultrasound-based risk stratification systems in detecting medullary thyroid carcinoma should not be overlooked. Findings from a systematic review with meta-analysis.

Ferrarazzo G, Camponovo C, Deandrea M, Piccardo A, Scappaticcio L, Trimboli P Clin Endocrinol (Oxf). 2022; 97(5):532-540.

PMID: 35419855 PMC: 9790631. DOI: 10.1111/cen.14739.

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