Comparison of 68Ga PET/CT to Other Imaging Studies in Medullary Thyroid Cancer: Superiority in Detecting Bone Metastases

Autor: George Coura Filho, Ana O. Hoff, Rossana Verónica Mendoza López, Luciana A. Castroneves, Alexander A. L. Jorge, Marcos Tavares, Raquel Ajub Moyses, Carlos Alberto Buchpiguel, Ricardo Miguel Costa de Freitas, Maria Adelaide Albergaria Pereira, Raphael Salles
Rok vydání: 2018
Předmět:
Adult
Male
medicine.medical_specialty
Endocrinology
Diabetes and Metabolism
Clinical Biochemistry
Context (language use)
Bone Neoplasms
Gallium Radioisotopes
Neuroendocrine tumors
Biochemistry
Sensitivity and Specificity
030218 nuclear medicine & medical imaging
03 medical and health sciences
Young Adult
0302 clinical medicine
Endocrinology
Internal medicine
Positron Emission Tomography Computed Tomography
Carcinoma
Organometallic Compounds
Medicine
Humans
Prospective Studies
Thyroid Neoplasms
Aged
Ultrasonography
PET-CT
Lung
NEOPLASIAS DA TIREOIDE
medicine.diagnostic_test
business.industry
Biochemistry (medical)
Medullary thyroid cancer
Magnetic resonance imaging
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Carcinoma
Neuroendocrine
medicine.anatomical_structure
Positron emission tomography
030220 oncology & carcinogenesis
Female
business
Nuclear medicine
Zdroj: Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual)
Universidade de São Paulo (USP)
instacron:USP
ISSN: 1945-7197
Popis: Context Persistent disease after surgery is common in medullary thyroid cancer (MTC), requiring lifelong radiological surveillance. Staging workup includes imaging of neck, chest, abdomen, and bones. A study integrating all sites would be ideal. Despite the established use of gallium-68 (68Ga) positron emission tomography (PET)/CT with somatostatin analogues in most neuroendocrine tumors, its efficacy is controversial in MTC. Objective Evaluate the efficacy of 68Ga PET/CT in detecting MTC lesions and evaluate tumor expression of somatostatin receptors (SSTRs) associated with 68Ga PET/CT findings. Methods Prospective study evaluating 30 patients with MTC [group 1 (n = 16), biochemical disease; group 2 (n = 14), metastatic disease]. Patients underwent 68Ga PET/CT, bone scan, CT and ultrasound of the neck, CT of the chest, CT/MRI of the abdomen, and MRI of the spine. 68Ga PET/CT findings were analyzed by disease site as positive or negative and as concordant or discordant with conventional studies. Sensitivity and specificity were calculated using pathological or cytological analysis or unequivocal identification by standard imaging studies. Immunohistochemical analysis of SSTRs was compared with 68Ga PET/CT findings. Results In both groups, 68Ga PET/CT was inferior to currently used imaging studies except for bone scan. In group 2, 68Ga PET/CT sensitivities were 56%, 57%, and 9% for detecting neck lymph nodes, lung metastases, and liver metastases, respectively, and 100% for bone metastases, superior to the bone scan (44%). Expression of SSTRs, observed in 44% of tumors, was not associated with 68Ga-DOTATATE uptake. Conclusions 68Ga PET/CT does not provide optimal whole-body imaging as a single procedure in patients with MTC. However, it is highly sensitive in detecting bone lesions and could be a substitute for a bone scan and MRI.
Databáze: OpenAIRE
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