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EANM practice guideline for PET/CT imaging in medullary thyroid carcinoma

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Abstract

Background

Medullary thyroid carcinoma (MTC) is a malignant tumour derived from the para-follicular thyroid C cells. It may occur in sporadic or hereditary forms and surgery represent the primary cure.

Methods

Ultrasound examination and, in selected cases, cross-sectional anatomic imaging procedures, are adopted to stage the disease before primary surgery while different anatomic/morphologic and functional/molecular imaging procedures can be adopted in detecting persistent/recurrent disease. Positron emitting radiopharmaceuticals including fluorine-18 fluorodeoxyglucose (18F-FDG), fluorine-18 dihydroxyphenylalanine (18F-FDOPA) and somatostatin analogues labelled with gallium-68 (68Ga-SSA) tracks different metabolic pathways or receptor expression/functioning, and proved to be useful in detecting MTC recurrences/metastasis.

Conclusions

This practice guideline from the Thyroid Committee of the European Association of Nuclear Medicine (EANM), with involvement of external experts, provides recommendations based on updated literature’s evidences. The purpose of this practice guideline is to assist imaging specialists and clinicians in recommending, performing and interpreting the results of PET/CT with various radiopharmaceuticals in patients with MTC.

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Acknowledgements

This practice guideline summarizes the views of EANM Thyroid Committee and produces recommendations for which the EANM cannot be considered responsible. The recommendations should be adopted in the context of good nuclear medicine practice of nuclear and do not substitute national and international regulations. Before approval, this practice guideline was available to all EANM Committees and EANM National Societies of Nuclear Medicine. All comments, criticisms and suggestions have been considered for this EANM practice guideline.

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Authors and Affiliations

  1. Clinic for Nuclear Medicine and Thyroid Competence Centre, Imaging Institute of Southern Switzerland, Via Ospedale 6, CH-6500, Bellinzona, Switzerland

    Luca Giovanella & Giorgio Treglia

  2. Academic Department of Nuclear Medicine, Papageorgiu Hospital, Thessaloniki, Greece

    Ioannis Iakovou

  3. Department of Nuclear Medicine, Oncology Institute of Vojvodina, Sremska Kamenica, Serbia

    Jasna Mihailovic

  4. Department of Nuclear Medicine, University Hospital Marburg, Marburg, Germany

    Frederik A. Verburg & Markus Luster

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  1. Luca Giovanella
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  2. Giorgio Treglia
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  4. Jasna Mihailovic
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  5. Frederik A. Verburg
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Correspondence to Luca Giovanella.

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Conflict of interest

L.G. is member of Roche Diagnostics advisory board and received research grants and speaker fees from Roche Diagnostics, IBSA and Sanofi-Genzyme. F.A.V. has received research grants from Sanofi-Genzyme and speaker honoraria from Sanofi-Genzyme, Diasorin and Jubilant Draximage. M.L. has received research grants and speaker honoraria from Sanofi-Genzyme, Bayer and Astra Zeneca. G.T declares that he has no conflict of interest. I.I declares that he has no conflict of interest. JM declares that she has no conflict of interest.

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Giovanella, L., Treglia, G., Iakovou, I. et al. EANM practice guideline for PET/CT imaging in medullary thyroid carcinoma. Eur J Nucl Med Mol Imaging 47, 61–77 (2020). https://doi.org/10.1007/s00259-019-04458-6

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