Determination of medullary thyroid carcinoma metastases by 201Tl, 99Tcm(V)DMSA, 99Tcm-MIBI and 99Tcm-tetrofosmin

Adalet, İşık; Koçak, Mehmet; Oguz, Harika; Alagöl, Faruk; Cantez, Sema

doi:10.1097/00006231-199904000-00010

Cited by 26 publications

(4 citation statements)

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“…Bone scans are generally better for imaging bone lesions. Several other imaging techniques, e.g., thallium-201 thallous chloride ( 201 TICI), technetium-99m pentavalent dimercaptosuccinic acid ( 99m Tc(V)-DMSA), or 99m Tc-tetrofosmin have been analyzed (Adalet et al 1999;Ugur et al 1996) and were found to be complementary, often having a high sensitivity but a low speci®city. Octreotide scans have been shown to be quite sensitive in detecting lung metastases; however, this technique fails to visualize tumors less than 1 cm.…”

Section: Genotype-phenotype Correlationmentioning

confidence: 99%

Diagnosis and therapy of sporadic and familial medullary thyroid carcinoma

Gimm

Sutter²,

Dralle³

2001

Journal of Cancer Research and Clinical Oncology

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Medullary thyroid carcinoma (MTC) is a rare thyroid malignancy. About 75% are sporadic (sMTC) while the remaining 25% are hereditary (hMTC). The treatment of choice for both sMTC and hMTC is surgery. An adequate initial operation provides the best chance of cure. Hence, the diagnosis of MTC should be made preoperatively. In sMTC, ultrasound, ultrasound-guided fine-needle aspiration cytology and measurement of calcitonin levels (basal and after injection of calcitonin-stimulating reagents, e.g., pentagastrin) are sensitive diagnostic tools. In hMTC, identification of a germline mutation in the proto-oncogene RET is sufficient for making the diagnosis. Total thyroidectomy is recommended in all patients, sporadic and hereditary. In addition, lymphadenectomy of the cervicocentral and both cervicolateral compartments should be performed. The only indication to perform a less extensive operation may be given in young patients with hMTC. Sufficient treatment of MTC beyond local disease is still non-existent. Future research should concentrate on this issue.

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Section: Genotype-phenotype Correlationmentioning

confidence: 99%

Diagnosis and therapy of sporadic and familial medullary thyroid carcinoma

Gimm

Sutter²,

Dralle³

2001

Journal of Cancer Research and Clinical Oncology

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“…Ultrasound, CT, and MRI provide structural but no functional information. Conventional nuclear medicine studies with 99m Tc (V) dimercaptosuccinic acid, 99m Tc-sestamibi, 111 In-pentetreotide, and 131 I-metaiodobenzylguanidine have variable and often limited sensitivity (9)(10)(11)(12). The advent of 18 F-FDG PET added another imaging tool in the detection of recurrent MTC.…”

mentioning

confidence: 99%

Diagnostic Accuracy of 18F-FDG PET in Restaging Patients with Medullary Thyroid Carcinoma and Elevated Calcitonin Levels

Ong

Schöder²,

Patel³

et al. 2007

Journal of Nuclear Medicine

148

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Medullary thyroid carcinoma (MTC) is a rare endocrine tumor arising from the C-cells of the thyroid gland. Calcitonin is the principal serum tumor marker. A rising calcitonin level after total thyroidectomy for localized disease generally indicates residual, recurrent, or metastatic disease. The role of 18 F-FDG PET in MTC remains somewhat unclear. We reviewed our own experience with 18 F-FDG PET in postthyroidectomy MTC patients with elevated calcitonin. Methods: From our database, we identified patients with suspected residual, recurrent, or metastatic MTC and elevated calcitonin who had been referred for 18 F-FDG PET between January 2000 and October 2005. 18 F-FDG PET findings were classified as positive or negative on the basis of visual interpretation of the scan. Standardized uptake values (SUVs) were also calculated. The 18 F-FDG PET findings were verified by histopathologic examination, when available, or other imaging studies and clinical follow-up. Any negative 18 F-FDG PET result was considered false-negative. Results: Twentyeight patients underwent a total of 38 18 F-FDG PET studies. Calcitonin levels ranged from 106 to 541,000 pg/mL (median, 7,260 pg/mL). There were 23 true-positive, 1 false-positive, and 14 false-negative 18 F-FDG PET scans, yielding an overall sensitivity of 62%. There was no true-positive finding when calcitonin levels were below 509 pg/mL (n 5 5). Using an arbitrary cutoff of 1,000 pg/mL, we found that the sensitivity in scans with calcitonin levels greater than 1,000 pg/mL increased to 78% (21/27; 95% confidence interval, 58%-91%). The mean SUV of all lesions with 18 F-FDG uptake was 5.3 6 3.2 (range, 2.0-15.9). Among the 14 patients with false-negative 18 F-FDG PET findings, 8 had concurrent anatomic imaging studies and only 2 of these had positive findings. Conclusion: 18 F-FDG PET can detect residual, recurrent, or metastatic MTC with a reasonable sensitivity of 78% when the calcitonin level is above 1,000 pg/mL but appears of limited use if the calcitonin level is below 500 pg/mL.

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“…Tc-99m DMSA(V) is taken up by the primary as well as recurrent tumor, along with its metastasis, with sensitivity ranging from 19% to 88%. [34567891011]…”

Section: Discussionmentioning

confidence: 99%

Exploring the role of technitium-99m dimercaptosuccinyl acid (V) scan in medullary carcinoma thyroid patients with postoperative persistent hypercalcitoninemia in the era of positron emission tomography-computerized tomography

et al. 2014

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Background:Many radio-pharmaceuticals have been used over the years to localize the recurrences in patients with medullary carcinoma thyroid (MCT), including iodine-131-metaiodobenzylguanidine, thallium-201, technitium-99m dimercaptosuccinyl acid [Tc-99m DMSA (V)], Tc-99m methoxyisobutylisonitril, Tc-99 ethylenediamine diacetic acid/hydrazinonicotinyl-Tyr (3)-octreotide, and In-111 diethylenetriaminepenta-acetic acid-octreotide with varying sensitivities and specificities.Aims:The aim of this study is to explore the role of Tc-99m DMSA (V) scan in MCT patients with postoperative persistent hypercalcitoninemia in the positron emission tomography-computerized tomography (PET-CT) era.Materials and Methods:A retrospective review of 53 patients with proven sporadic MCT, who presented to our institution over a period 28 years from 1985 to 2012, was performed. Patients with persistently elevated levels of serum calcitonin (>150 pg/ml) were initially evaluated by a DMSA scan if conventional imaging failed to localize any focus of disease.Results and Conclusions:Our study showed that the postoperative levels of serum calcitonin significantly correlated with the overall survival of our patients and can possibly serve as a good prognostic marker. Tc-99m DMSA (V) scans demonstrated a sensitivity of 75%, specificity of 56%, a positive predictive value of 50%, and a negative predictive value of 80% in detecting metastasis in postoperative persistent hypercalcitoninemia. Our study showed that Tc-99m DMSA (V) scanning is an affordable and a reasonably sensitive imaging agent for localization of recurrent/metastatic disease. PET-CT seems to be a useful complementary tool and needs to be kept in the armamentarium for diagnosis of recurrence especially in cases of discordance between Tc-99m DMSA (V) scan and the serum calcitonin levels.

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Determination of medullary thyroid carcinoma metastases by 201Tl, 99Tcm(V)DMSA, 99Tcm-MIBI and 99Tcm-tetrofosmin

Cited by 26 publications

References 0 publications

Diagnosis and therapy of sporadic and familial medullary thyroid carcinoma

Diagnosis and therapy of sporadic and familial medullary thyroid carcinoma

Diagnostic Accuracy of 18F-FDG PET in Restaging Patients with Medullary Thyroid Carcinoma and Elevated Calcitonin Levels

Exploring the role of technitium-99m dimercaptosuccinyl acid (V) scan in medullary carcinoma thyroid patients with postoperative persistent hypercalcitoninemia in the era of positron emission tomography-computerized tomography

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