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Somatostatin receptor imaging of thyroid tissue and differentiated thyroid cancer using gallium-68-labeled radiotracers—a review of clinical studies

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Abstract

Introduction

The rise in thyroid cancer incidence, especially papillary thyroid cancer (PTC), has underscored the need for improved diagnostic methods and management strategies. Herein, we aim to comprehensively review the evolving landscape in thyroid cancer diagnosis and the potential utility of Gallium-68 (Ga-68) based somatostatin receptor imaging.

Methods

We reviewed the clinical studies involving Ga-68 based radiotracers by looking at the following literature databases -PUBMED, EMBASE, WEB OF SCIENCE and COCHRANE. We employed a detailed search strategy with the following search terms; PubMed: (“gallium Ga 68 dotatate” [Supplementary Concept]) AND (“Thyroid Gland”[Mesh] OR “Thyroid Nodule”[Mesh] OR “Thyroid Neoplasms”[Mesh]), Embase (“gallium 68” AND “Thyroid Disease”), Web of Science: (“Gallium 68 and Thyroid”).

Results

A comparison between Ga-68 DOTATATE and Ga-68 DOTANOC showed similar sensitivities but a higher uptake for Ga-68 DOTATATE. Studies comparing Ga-68-based SSTR PET with FDG PET highlighted the potential advantages of both approaches, with Ga-68-based SSTR PET being more specific in certain cases.

Discussion

Ga-68-based somatostatin receptor imaging displays clinical utility in RAI-R DTC, offering valuable insight into detecting skeletal lymph node metastases. Notably, it shows potential as a primary imaging tool, potentially augmenting the role of FDG PET. However, SSTR PET imaging’s efficacy in distinguishing benign from malignant thyroid nodules varies, with a complex interplay of factors influencing its specificity, indicating its value as an adjunct to existing methods, warranting further research for a refined role in thyroid cancer management.

Conclusion

Although study variations exist, Ga-based somatostatin receptor imaging holds potential as a complementary tool alongside diagnostic methods in thyroid cancer diagnosis, with particular relevance to RAI-R DTC. In carefully selected patients demonstrating the presence of Ga-68 DOTATATE avid lesions, further exploration, and investigation into the potential utilization of Lu177 DOTATATE are warranted.

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Authors and Affiliations

  1. Division of Endocrinology, Diabetes & Metabolism, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Reza Pishdad

  2. Division of Endocrinology, Diabetes & Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Reza Pishdad & Prasanna Santhanam

  3. Division of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland

    Giorgio Treglia

  4. Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland

    Giorgio Treglia

  5. Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland

    Giorgio Treglia

  6. Kasturba Medical College, Manipal, India

    Ami Mehta

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RP: Conceptualization, review of literature, writing- original draft preparationGT: Review of literature, writing- original draft preparationAM: Conceptualization, writing- original draft preparationPS: Conceptualization, review of literature, writing- original draft preparation and editing.

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Correspondence to Reza Pishdad.

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Pishdad, R., Treglia, G., Mehta, A. et al. Somatostatin receptor imaging of thyroid tissue and differentiated thyroid cancer using gallium-68-labeled radiotracers—a review of clinical studies. Endocrine (2024). https://doi.org/10.1007/s12020-024-03779-3

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