Abstract Persistent disease after surgery is common in medullary thyroid cancer (MTC) requiring lifelong radiological surveillance. Staging work-up includes imaging of neck, chest, abdomen and bones. A study integrating all sites would be ideal. Despite the established use of 68Ga PET/CT with somatostatin analogs in most neuroendocrine tumors, in MTC its efficacy is controversial. Objective Evaluate the efficacy of 68Ga PET/CT in detecting MTC lesions and evaluate tumor expression of somatostatin receptors (SSTR) associating with 68Ga PET/CT findings. Methods Prospective study evaluating 30 MTC patients; Group 1 (N=16): Biochemical disease and Group 2 (N=14): Metastatic disease. Patients underwent 68Ga PET/CT, bone scan, neck CT and US, CT chest, CT/MRI abdomen, MRI spine. 68Ga PET/CT findings were analyzed by disease site as positive or negative and as concordant or discordant with conventional studies. Sensitivity and specificity were calculated using pathological, cytological analysis or unequivocal identification by standard imaging studies. Immunohistochemical analysis of SSTRs were compared with 68Ga PET/CT findings. Results In both groups 68Ga PET/CT was inferior than currently used imaging studies except for bone scan. In group 2, 68Ga PET/CT sensitivities were 56%, 57% and 9% for detecting neck lymph nodes, lung and liver metastases and 100% for bone metastases, superior than bone scan (44%). Expression of SSTRs, observed in 44% of tumors, was not associated with68Ga DOTATATE uptake. Conclusions 68Ga PET/CT does not provide optimal whole-body imaging as a single procedure in patients with MTC. However, is highly sensitive detecting bone lesions and could substitute bone scan and MRI. Copyright © 2018 Endocrine Society
Journal of Clinical Endocrinology and Metabolism – Oxford University Press
Published: May 28, 2018
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