Öz
Objective: The aim of study is to evaluate the impact of fluorodeoxyglucose positron emission tomography (FDG PET) in the follow-up of medullary thyroid carcionma (MTC) patients who had elevated calcitonin levels after surgery. Materials and Methods: Six patients diagnosed with MTC who referred to our clinic for FDG PET imaging because of the elevated calcitonin levels were included. All were male. Mean age was 52±8 years. Results: In 4 patients whose calcitonin levels were 75 pg/ml, 90pg/ml, 94 pg/ml and 127 pg/ml respectively, there was no evidence for recurrence or metastasis of MTC on FDG PET. FDG PET findings were positive in 2 patients whose calcitonin levels were 1300 pg/ml and 2110 pg/ml respectively. In these patients lymph node metastases and bone metastases were detected. Conclusion: It seems that there is no place to FDG PET for routine imaging of MTC. But here calcitonin levels are important. In patients who have calcitonin levels higher than 1000 pg/ml FDG PET can be very useful and detect a lot of lesion foci. Also allowing to whole body imaging is a significant advantage of it.
Anahtar Kelimeler
Kaynakça
- Vitale G, Caraglia M, Ciccarelli A, Lupoli G, Abbruzzese A, Tagliaferri P, et al. Current approaches and perspectives in the therapy of medullary thyroid carcinoma. Cancer. 2001;91(9):1797–808.
- Leboulleux S, Baudin E, Travagli JP, Schlumberger M. Medullary thyroid carcinoma. Clin Endocrinol (Oxf). 2004;61(3):299–310.
- Busnardo B, Girelli ME, Simioni N, Nacamulli D, Busetto E. Non parallel patterns of calcitonin and carcinoembryonic antigen levels in the follow-up of medullary thyroid carcinoma. Cancer. 1984;53(2):278–85.
- Quayle FJ, Moley JF. Medullary thyroid carcinoma: including MEN 2A and MEN 2B syndromes. J Surg Oncol. 2005;89(3):122–9.
- Hundahl SA, Fleming ID, Fremgen AM, Menck HR. A National Cancer Data Base report on 53,856 cases of thyroid carcinoma treated in the U.S, 1985-1995. Cancer. 1998;83(12):2638–48.
- Lairmore TC, Wells SA Jr. Medullary carcinoma of the thyroid: current diagnosis and management. Semin Surg Oncol. 1991;7(2):92–9.
- Bergholm U, Adami HO, Bergström R, Johansson H, Lundell G, Telenius-Berg M, 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.
- Pitt SC, Moley JF. Medullary, anaplastic, and metastatic cancers of the thyroid. Semin Oncol. 2010;37(6):567-79.
- Kebebew E, Ituarte PH, Siperstein AE, Duh QY, Clark OH. Medullary thyroid carcinoma: clinical characteristics, treatment, prognostic factors, and a comparison of staging systems. Cancer. 2000;88(5):1139–48.
- Ong SC, Schöder H, Patel SG, Tabangay-Lim IM, Doddamane I, Gönen M,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. 17 18
- A, Schurrat T, et al. Improved tumour detection by gastrin receptor scintigraphy in patients with metastasised medullary thyroid carcinoma. Eur J Nucl Med Mol Imaging. 2006;33(11):1273–9.
Öz
ÖZET
Amaç: Çalışmanın amacı cerrahi sonrası yüksek kalsitonin seviyelerine sahip medüller tiroid karsinomlu (MTK) hastaların takibinde florodeoksiglikoz pozitron emisyon tomografisinin (FDG PET) etkinliğini değerlendirmektedir. Gereç ve Yöntemler: Çalışmaya yüksek kalsitonin seviyeleri nedeniyle kliniğimize FDG PET görüntüleme için yönlendirilen MTK tanılı 6 hasta dahil edildi. Bütün hastalar erkekti. Yaş ortalaması 52±8 idi.
Bulgular: Kalsitonin seviyeleri sırasıyla75 pg/ml, 90pg/ml, 94 pg/ml ve 127 pg/ml olan 4 hastada FDG PET görüntülemede MTK’nın rekürrens ya da metastazını düşündürecek bulgu izlenmedi. Kalsitonin seviyeleri 1300 pg/ml ve 2110 pg/ml olan 2 hastada ise FDG PET bulguları pozitifti. Bu hastalarda lenf nodu ve kemik metastazları saptandı.
Tartışma: Öyle görünüyor ki MTK’nın rutin görüntülemesinde FDG PET’e yer yoktur. Ancak burada kalsitonin seviyeleri önem arz etmektedir. Kalsitonin seviyeleri 1000 pg/ml’den yüksek hastalarda FDG PET oldukça faydalı olabilmekte ve birçok lezyon odağını tespit edebilmektedir. Ayrıca tüm vücut görüntülemeye olanak sağlaması da önemli bir avantajıdır.
Anahtar kelimeler: Medüller tiroid karsinomu, FDG PET, Kalsitonin.
ABSTRACT
Objective: The aim of study is to evaluate the impact of fluorodeoxyglucose positron emission tomography (FDG PET) in the follow-up of medullary thyroid carcionma (MTC) patients who had elevated calcitonin levels after surgery.
Materials and Methods: Six patients diagnosed with MTC who referred to our clinic for FDG PET imaging because of the elevated calcitonin levels were included. All were male. Mean age was 52±8 years.
Results: In 4 patients whose calcitonin levels were 75 pg/ml, 90pg/ml, 94 pg/ml and 127 pg/ml respectively, there was no evidence for recurrence or metastasis of MTC on FDG PET. FDG PET findings were positive in 2 patients whose calcitonin levels were 1300 pg/ml and 2110 pg/ml respectively. In these patients lymph node metastases and bone metastases were detected.
Conclusion: It seems that there is no place to FDG PET for routine imaging of MTC. But here calcitonin levels are important. In patients who have calcitonin levels higher than 1000 pg/ml FDG PET can be very useful and detect a lot of lesion foci. Also allowing to whole body imaging is a significant advantage of it.
Key words: Medullary thyroid carcinoma, FDG PET, Calcitonin.
Anahtar Kelimeler
Kaynakça
- Vitale G, Caraglia M, Ciccarelli A, Lupoli G, Abbruzzese A, Tagliaferri P, et al. Current approaches and perspectives in the therapy of medullary thyroid carcinoma. Cancer. 2001;91(9):1797–808.
- Leboulleux S, Baudin E, Travagli JP, Schlumberger M. Medullary thyroid carcinoma. Clin Endocrinol (Oxf). 2004;61(3):299–310.
- Busnardo B, Girelli ME, Simioni N, Nacamulli D, Busetto E. Non parallel patterns of calcitonin and carcinoembryonic antigen levels in the follow-up of medullary thyroid carcinoma. Cancer. 1984;53(2):278–85.
- Quayle FJ, Moley JF. Medullary thyroid carcinoma: including MEN 2A and MEN 2B syndromes. J Surg Oncol. 2005;89(3):122–9.
- Hundahl SA, Fleming ID, Fremgen AM, Menck HR. A National Cancer Data Base report on 53,856 cases of thyroid carcinoma treated in the U.S, 1985-1995. Cancer. 1998;83(12):2638–48.
- Lairmore TC, Wells SA Jr. Medullary carcinoma of the thyroid: current diagnosis and management. Semin Surg Oncol. 1991;7(2):92–9.
- Bergholm U, Adami HO, Bergström R, Johansson H, Lundell G, Telenius-Berg M, 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.
- Pitt SC, Moley JF. Medullary, anaplastic, and metastatic cancers of the thyroid. Semin Oncol. 2010;37(6):567-79.
- Kebebew E, Ituarte PH, Siperstein AE, Duh QY, Clark OH. Medullary thyroid carcinoma: clinical characteristics, treatment, prognostic factors, and a comparison of staging systems. Cancer. 2000;88(5):1139–48.
- Ong SC, Schöder H, Patel SG, Tabangay-Lim IM, Doddamane I, Gönen M,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. 17 18
- A, Schurrat T, et al. Improved tumour detection by gastrin receptor scintigraphy in patients with metastasised medullary thyroid carcinoma. Eur J Nucl Med Mol Imaging. 2006;33(11):1273–9.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Orjinal Çalışma |
| Yazarlar | |
| Yayımlanma Tarihi | 3 Aralık 2014 |
| Yayımlandığı Sayı | Yıl 2014 Cilt: 4 Sayı: 3 |
