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Medullary Thyroid Carcinoma

  • Jean-François Chatal
  • Françoise Kraeber-Bodéré
  • David M. Goldenberg
  • Jacques Barbet
Chapter
Part of the Medical Radiology book series (MEDRAD)

Abstract

Overall survival after initial surgery in patients diagnosed with MTC is quite variable, but the rate decreases substantially after discovery of distant metastases depending on prognostic indicator values. In this context, nuclear medicine can play an important role both with diagnostic PET imaging, and radionuclide therapy. Among available imaging techniques, CT is the best for liver and lung and MRI for bone/bone marrow. MRI should be performed in MTC patients with increased serum calcitonin levels, even when bone scintigraphy is normal. FDG-PET/CT should be recommended for exploration of neck, mediastinum, and lungs, and CT and MRI for exploration of, respectively, liver and bone/bone marrow. There is a need for prognostic indicators allowing to have a clear distinction between high-risk patients who should be treated and low-risk patients who justify a “watchful waiting” management. The prognostic value of calcitonin (Ct) doubling time (DT) have been shown to be quite favorable. For this purpose, it can be recommended that sequential measurements (every month) of Ct serum levels be performed after primary surgery in the event of persisting abnormal titers allowing to calculate CtDT after a few months. Among current treatment modalities, chemotherapy is not accepted as a useful treatment of patients with metastatic disease. Effectiveness of radioimmunotherapy has been clearly documented as well as that of vandetanib, a multikinase inhibitor which has been approved for treatment of metastatic MTC.

Keywords

Vascular Endothelial Growth Factor Medullary Thyroid Carcinoma Medullary Thyroid Cancer Multikinase Inhibitor Medullary Thyroid Carcinoma Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Jean-François Chatal
    • 1
  • Françoise Kraeber-Bodéré
    • 2
    • 3
  • David M. Goldenberg
    • 4
  • Jacques Barbet
    • 2
  1. 1.GIP ArronaxUniversity of NantesNantes-Saint-HerblainFrance
  2. 2.Cancer Research Center, CRCNA, Institut de BiologieINSERM UMR892NantesFrance
  3. 3.Nuclear Medicine Department, University HospitalRené Gauducheau Cancer Center, IRCNANantes-Saint-HerblainFrance
  4. 4.Garden State Cancer CenterCenter for Molecular Medicine and ImmunologyBellevilleUSA

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