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Multiparametric PET imaging in thyroid malignancy characterizing tumour heterogeneity: somatostatin receptors and glucose metabolism

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Radiolabelled somatostatin (SST) analogues have proven useful in diagnosing tumours positive for SST receptor (SSTR). As different subtypes of SSTR are expressed on the tumour cell surface, the choice of appropriate therapeutic SST analogue is crucial. We evaluated the SSTR status of thyroid cancer patients who had signs of progressive disease comparing different SSTR ligands for PET imaging to evaluate possible further therapeutic options.

Methods

PET with 68Ga-radiolabelled SSTR ligands DOTA lanreotide (DOTA-LAN), DOTA-Tyr3 octreotide (DOTA-TOC) and 18F-FDG was performed in 31 patients with thyroid cancer (TC). These 31 patients comprised 18 with radioiodine non-avid differentiated TC (DTC) including 6 papillary TC (PTC), 8 follicular TC (FTC) and 4 oxyphilic TC (oxyTC), 5 with anaplastic TC (ATC), and 8 with medullary TC (MTC). The PET results were compared in a region-based evaluation.

Results

All patients underwent a PET study with 68Ga-DOTA-LAN, 28 patients with 68Ga-DOTA-TOC and 28 patients with 18F-FDG. A lack of SSTR expression was found in 13 of the 31 patients (42 %) with negative results with both SSTR tracers in 12 patients. Ambiguous results with both SSTR tracers were observed in one patient. High tracer uptake in SSTR PET images was seen in seven DTC patients (39 %; two PTC, three FTC, two oxyTC), in four ATC patients (80 %) and in six MTC patients (75 %). Lesions showing aerobic glycolysis on 18F-FDG PET were found in 24 of 28 patients (86 %) with corresponding positive results with 68Ga-DOTA-LAN in 35 % and with 68Ga-DOTA-TOC in 29 %.

Conclusion

The heterogeneous SSTR profile of TC tumour lesions needs to be evaluated using different SSTR PET tracers to characterize more closely the SSTR subtype affinities in patients with progressive TC in order to further stratify therapy with SSTR therapeutics.

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Compliance with ethical standards

Conflicts of Interest

None.

Informed consent

This study was retrospective in nature and formal consent was not required. All patients gave written informed consent before undergoing each of the imaging modalities according to institutional guidelines.

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Authors and Affiliations

  1. Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria

    Tatjana Traub-Weidinger

  2. Department of Nuclear Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria

    Tatjana Traub-Weidinger, Elisabeth von Guggenberg, Georg Dobrozemsky, Bernhard Nilica, Dorota Kendler & Irene Johanna Virgolini

  3. Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria

    Daniel Putzer & Reto Bale

Authors
  1. Tatjana Traub-Weidinger
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  2. Daniel Putzer
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  3. Elisabeth von Guggenberg
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  4. Georg Dobrozemsky
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  5. Bernhard Nilica
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  6. Dorota Kendler
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  7. Reto Bale
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  8. Irene Johanna Virgolini
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Correspondence to Irene Johanna Virgolini.

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Traub-Weidinger, T., Putzer, D., von Guggenberg, E. et al. Multiparametric PET imaging in thyroid malignancy characterizing tumour heterogeneity: somatostatin receptors and glucose metabolism. Eur J Nucl Med Mol Imaging 42, 1995–2001 (2015). https://doi.org/10.1007/s00259-015-3114-6

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  • DOI: https://doi.org/10.1007/s00259-015-3114-6

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