PET/CT with various radiopharmaceuticals in the complex diagnosis of medullary thyroid carcinoma: a review

Abstract

INTRODUCTION: Medullary carcinoma is a rare malignant neuroendocrine tumor of the thyroid gland. Medullary thyroid carcinoma (MTC) has no specific clinical symptoms. Due to the absence of specific symptoms, the disease is usually diagnosed at the stage of metastatic lesions of regional lymph nodes, and sometimes, internal organs. The five- and ten-year survival after detection of distant metastases is 25% and 10%, respectively.OBJECTIVE: To analyze the available foreign and domestic literature to determine the role of PET/CT with various radiopharmaceuticals in the complex radiological diagnosis of MTC.MATERIALS AND METHODS: A search was made for scientific publications and clinical recommendations in the information and analytical systems PudMed, elibrary over the past ten years, dedicated to the diagnosis of MTC, including PET/CT with 18F-DOPA, 18F-FDG, 68Ga-DOTA peptides, etc. by keywords «medullary thyroid cancer», «medullary thyroid carcinoma», «PET/CT», «18F-L-dihydroxyphenylalanine», «18F-DOPA», «18F-DOPA», «68Ga-DOTA peptides», «68Ga-DOTA-peptides», «theranostics», «theranostics».RESULTS: The analysis of publications demonstrated the prospects for the use of PET/CT with various radiopharmaceuticals for the diagnosis of recurrent tumors and the prevalence of the process in biochemical recurrence of MTC, as well as the possibility of peptide-receptor radionuclide therapy for the treatment of advanced forms of the disease. The choice of radiopharmaceuticals is based on the results of laboratory diagnostics and conventional methods of anatomical imaging. PET/CT with 68Ga-DOTA peptides is performed to predict the effectiveness of peptide-receptor radionuclide therapy.CONCLUSION: PET/CT with various radiopharmaceuticals makes a significant contribution to the diagnosis of recurrent tumors, assessment of the prevalence of the tumor process and selection of patients for peptide-receptor radionuclide therapy.