68Ga-DOTATATE PET/CT on the Follow-up of Patients with Medullary Thyroid Carcinoma

Yıl 2023, Cilt: 4 Sayı: 2 - Experimental and Applied Medical Science 2023, 4, 2., 526 - 531, 30.11.2023

Ebuzer Kalender Vuslat Çimen Umut Elboga Ufuk Çimen Zeki Çelen

https://doi.org/10.46871/eams.1364159

Öz

The purpose of this study is to evaluate the impact of 68Ga-DOTATE PET/CT on the management of medullary thyroid carcinoma (MTC). Eighteen patients (9 males and 9 females) with MTC who underwent 68Ga-DOTATE PET/CT for elevated calcitonin(Ct) levels were included in this study. Histopathological data, laboratory findings, 68Ga-DOTATE PET/CT findings were evaluated for each patient. 68Ga-DOTATATE PET/CT imaging findings were negative in 5 of 18 patients (27.8%) and positive in 13 of 18 patients (72.2%). The mean Ct level of patients with positive findings was higher than others. 68Ga-DOTATATE PET/CT was insufficient for detecting liver metastases in two patients who exhibited hypermetabolic uptakes consistent with solitary metastases in the liver on 18FDG-PET/CT. We believe that 68Ga-DOTATATE PET/CT plays an important role in the management of MTC patients with recurrent or metastatic disease. Its sensitivity is directly proportional to the levels of serum Ct. However, it may have limitations in detecting liver metastases.

Anahtar Kelimeler

MTC, 68Ga-DOTATATE, PET/CT, Ct

Etik Beyan

Ethics approval and consent to participate: The study was performed according to the principles of the Declaration of Helsinki, and approval was granted by the Local Ethics Committee (date: 24.05.2023, no: 172).

Kaynakça

• 1. Wells SA Jr, Asa SL, Dralle H, et al. Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma: the American Thyroid Association Guidelines Task Force on medullary thyroid carcinoma. Thyroid 2015; 25: 567–610.
• 2. Jayarajah U, Fernando A, Prabashani S, et al. Incidence and histological patterns of thyroid cancer in Sri Lanka 2001-2010: an analysis of national cancer registry data. BMC cancer 2018; 18: 163.
• 3. Revised American thyroid association guidelines for the management of medullary thyroid carcinoma. Pediatrics. 2018;142(6), e20183062. https://doi.org/10.1542/ peds.2018-3062.
• 4. Vitale G, Caraglia M, Ciccarelli A, et al. Current approaches and perspectives in the therapy of medullary thyroid carcinoma. Cancer. 2001;91(9):1797–808.
• 5. Treglia G, Villani MF, Giordano A, et al. Detection rate of recurrent medullary thyroid carcinoma using fluorine-18 fluorodeoxyglucose positron emission tomography: a meta-analysis. Endocrine 2012; 42: 535–45.
• 6. Leboulleux S, Baudin E, Travagli JP, et al. Medullary thyroid carcinoma. Clin Endocrinol (Oxf). 2004;61(3):299–310.
• 7. Roman S, Lin R, Sosa JA. Prognosis of medullary thyroid carcinoma: demographic, clinical, and pathologic predictors of survival in 1252 cases. Cancer. 2006;107:2134–42.
• 8. Lairmore TC, Wells SA Jr. Medullary carcinoma of the thyroid: current diagnosis and management. Semin Surg Oncol. 1991;7(2):92–9.
• 9. Bergholm U, Adami HO, Bergström R, et al. Clinical characteristics in sporadic and familial medullary thyroid carcinoma: a nationwide study of 249 patients in Sweden from 1959 through 1981. Cancer. 1989;63(6):1196–204.
• 10. Kebebew E, Ituarte PH, Siperstein AE, et al. Medullary thyroid carcinoma: clinical characteristics, treatment, prognostic factors, and a comparison of staging systems. Cancer. 2000;88(5):1139–48.
• 11. Machens A and Dralle H. Biomarker-based risk stratification for previously untreated medullary thyroid cancer. J Clin Endocrinol Metab 2010; 95: 2655–2663.
• 12. Treglia G, Castaldi P, Villani MF, et al. Comparison of 18F-DOPA, 18F-FDG and 68Ga-somatostatin analogue PET/CT in patients with recurrent medullary thyroid carcinoma. Eur J Nucl Med Mol Imag. 2012;39(4):569–580.
• 13. Pacini F, Castagna MG, Cipri C, et al. Medullary thyroid carcinoma. Clin Oncol (R Coll Radiol) 2010;22: 475-85.
• 14. Rendl G, Manzl M, Hitzl W, et al. Long-term prognosis of medullary thyroid carcinoma. Clinical endocrinology. 2008;69(3):497-505.
• 15. Filetti S, Durante C, Hartl D, et al. Thyroid cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2019;30:1856-83.
• 16. Rufini V, Castaldi P, Treglia G, et al. Nuclear medicine procedures in the diagnosis and therapy of medullary thyroid carcinoma. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie. 2008;62(3):139-46.
• 17. Ong SC, Schöder H, Patel SG, et al. Diagnostic accuracy of 18F-FDG PET in restaging patients with medullary thyroid carcinoma and elevated calcitonin levels. J Nucl Med. 2007;48(4):501–7.
• 18. Diehl M, Risse JH, Brandt-Mainz K, et al. Fluorine-18 fluorodeoxyglucose positron emission tomography in medullary thyroid cancer: results of a multicentre study. Eur J Nucl Med. 2001;28(11):1671–6.
• 19. De Groot JW, Links TP, Jager PL, et al. Impact of 18F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in patients with biochemical evidence of recurrent or residual medullary thyroid cancer. Ann Surg Oncol. 2004;11(8):786–94.
• 20. Deppen SA, Liu E, Blume JD, et al. Safety and Efficacy of 68Ga-DOTATATE PET/CT for Diagnosis, Staging, and Treatment Management of Neuroendocrine Tumors. Journal of nuclear medicine : official publication, J Nucl Med. 2016;57(5):708-14.
• 21. Conry BG, Papathanasiou ND, Prakash V, et al. Comparison of (68)Ga-DOTATATE and (18)F-fluorodeoxyglucose PET/CT in the detection of recurrent medullary thyroid carcinoma. Eur J Nucl Med Mol Imaging. 2010;37(1):49-57.
• 22. Naswa N, Sharma P, Suman Kc S, et al. Prospective evaluation of 68Ga-DOTA-NOC PET-CT in patients with recurrent medullary thyroid carcinoma: comparison with 18F-FDG PET-CT. Nucl Med Commun. 2012;33(7):766-74.
• 23. Ozkan ZG, Kuyumcu S, Uzum AK, et al. Comparison of (6)(8)Ga-DOTATATE PET-CT, (1)(8)F-FDG PET-CT and 99mTc-(V)DMSA scintigraphy in the detection of recurrent or metastatic medullary thyroid carcinoma. Nucl Med Commun. 2015;36(3):242-50.
• 24. Papotti M, Kumar U, Volante M, et al. Immunohistochemical detection of somatostatin receptor types 1-5 in medullary carcinoma of the thyroid. Clin Endocrinol. 2001;54(5):641–649. 25. Tuncel M, Kılckap S, Suslu N. Clinical impact of 68Ga DOTATATE PET CT imaging in patients with medullary thyroid cancer. Annals Nucl Med (2020) 34:663–674.
• 26. Tran K, Khan S, Taghizadehasl M, et al. Gallium-68 dotatate PET/CT is superior to other imaging modalities in the detection of medullary carcinoma of the thyroid in the presence of high serum calcitonin. Hellenic J Nucl Med. 2015;18(1):19–24.
• 27. Sahin E, Elboga U. The role of tumour biomarkers in choosing the appropriate positron emission tomography imaging in follow-up of medullary thyroid cancer. J Med Imaging Radiat Oncol. 2020;64(6):756–761.
• 28. Pajak C, Cadili L, Nabata K, et al. 68Ga-DOTATATE-PET shows promise for diagnosis of recurrent or persistent medullary thyroid cancer: A systematic reviewAm J Surg. 2022;224(2):670-675.