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Comparison of 18F-DOPA, 18F-FDG and 68Ga-somatostatin analogue PET/CT in patients with recurrent medullary thyroid carcinoma

  • Giorgio TregliaEmail author
  • Paola Castaldi
  • Maria Felicia Villani
  • Germano Perotti
  • Chiara de Waure
  • Angelina Filice
  • Valentina Ambrosini
  • Nadia Cremonini
  • Monica Santimaria
  • Annibale Versari
  • Stefano Fanti
  • Alessandro Giordano
  • Vittoria Rufini
Original Article

Abstract

Purpose

To retrospectively evaluate and compare 18F-FDG, 18F-DOPA and 68Ga-somatostatin analogues for PET/CT in patients with residual/recurrent medullary thyroid carcinoma (MTC) suspected on the basis of elevated serum calcitonin levels.

Methods

Included in the study were 18 patients with recurrent MTC in whom functional imaging with the three tracers was performed. The PET/CT results were compared on a per-patient basis and on a per-lesion-basis.

Results

At least one focus of abnormal uptake was observed on PET/CT in 13 patients with 18F-DOPA (72.2% sensitivity), in 6 patients with 68Ga-somatostatin analogues (33.3%) and in 3 patients with 18F-FDG (16.7%) (p < 0.01). There was a statistically significant difference in sensitivity between 18F-DOPA and 18F-FDG PET/CT (p < 0.01) and between 18F-DOPA and 68Ga-somatostatin analogue PET/CT (p = 0.04). Overall, 72 lesions were identified on PET/CT with the three tracers. 18F-DOPA PET/CT detected 85% of lesions (61 of 72), 68Ga-somatostatin analogue PET/CT 20% (14 of 72) and 18F-FDG PET/CT 28% (20 of 72). There was a statistically significant difference in the number of lymph node, liver and bone lesions detected with the three tracers (p < 0.01). In particular, post-hoc tests showed a significant difference in the number of lymph node, liver and bone lesions detected by 18F-DOPA PET/CT and 18F-FDG PET/CT (p < 0.01 for all the analyses) and by 18F-DOPA PET/CT and 68Ga-somatostatin analogue PET/CT (p < 0.01 for all the analyses). The PET/CT results led to a change in management of eight patients (44%).

Conclusion

18F-DOPA PET/CT seems to be the most useful imaging method for detecting recurrent MTC lesions in patients with elevated serum calcitonin levels, performing better than 18F-FDG and 68Ga-somatostatin analogue PET/CT. 18F-FDG may complement 18F-DOPA in patients with an aggressive tumour.

Keywords

Positron emission tomography Medullary thyroid carcinoma PET/CT Diagnosis Neuroendocrine tumours 

Notes

Conflicts of interest

None

Disclosures

None

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Giorgio Treglia
    • 1
    Email author
  • Paola Castaldi
    • 1
  • Maria Felicia Villani
    • 1
  • Germano Perotti
    • 1
  • Chiara de Waure
    • 2
  • Angelina Filice
    • 3
  • Valentina Ambrosini
    • 4
  • Nadia Cremonini
    • 5
  • Monica Santimaria
    • 6
  • Annibale Versari
    • 3
  • Stefano Fanti
    • 4
  • Alessandro Giordano
    • 1
  • Vittoria Rufini
    • 1
  1. 1.Institute of Nuclear Medicine, Policlinico A. GemelliCatholic University of the Sacred HeartRomeItaly
  2. 2.Institute of Hygiene, Policlinico A. GemelliCatholic University of the Sacred HeartRomeItaly
  3. 3.Nuclear Medicine UnitSanta Maria Nuova HospitalReggio EmiliaItaly
  4. 4.Nuclear Medicine Unit, Sant’Orsola-Malpighi HospitalUniversity of BolognaBolognaItaly
  5. 5.Unit of EndocrinologyOspedale MaggioreBolognaItaly
  6. 6.PET Radiopharmacy Unit, Policlinico A. GemelliCatholic University of the Sacred HeartRomeItaly

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