Abstract
Purpose
In patients with medullary thyroid carcinoma (MTC), rising levels of the tumour markers calcitonin and CEA after primary surgery indicate tumour recurrence or metastases. The only chance of cure is the resection of localised tumour tissue. For positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) and 18F-dihydroxyphenylalanine (18F-DOPA), sensitivities of 78% and 63% have been reported, but in a considerable percentage of MTC patients the source of tumour marker elevation is not detected. The aim of this retrospective data evaluation was to compare the value of PET with 18F-FDG, 18F-DOPA and the amino acid tracer 3-O-methyl-6-[18F]fluoro-DOPA (18F-OMFD) in the detection of MTC recurrence.
Methods
Fifteen patients with elevated calcitonin were investigated with PET as part of their individual clinical work-up. All patients underwent 18F-FDG PET and 18F-DOPA PET, and ten patients underwent 18F-OMFD PET.
Results
With 18F-FDG, seven patients showed foci in the neck, mediastinum, upper abdomen or bone. In seven patients, 18F-DOPA revealed suspicious foci; five of these seven patients showed partially corresponding uptake of 18F-FDG in the neck and mediastinum. Two of these patients underwent surgery and metastases were verified. With 18F-OMFD, a small focus in the liver was suspected in one patient without a correlate on 18F-FDG PET, 18F-DOPA PET or conventional imaging.
Conclusion
18F-FDG and 18F-DOPA showed foci that were highly suspicious for local recurrence or metastasis of MTC, although histological verification in these patients with numerous previous surgical interventions was performed in only two patients. The amino acid tracer 18F-OMFD had no diagnostic impact in these patients.
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Beuthien-Baumann, B., Strumpf, A., Zessin, J. et al. Diagnostic impact of PET with 18F-FDG, 18F-DOPA and 3-O-methyl-6-[18F]fluoro-DOPA in recurrent or metastatic medullary thyroid carcinoma. Eur J Nucl Med Mol Imaging 34, 1604–1609 (2007). https://doi.org/10.1007/s00259-007-0425-2
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DOI: https://doi.org/10.1007/s00259-007-0425-2