Department of Nuclear Medicine, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpasa Istanbul, Turkey.
Hell J Nucl Med. 2020 Sep-Dec;23(3):321-329. doi: 10.1967/s002449912220.
Medullary thyroid cancer (MTC) is an aggressive form of thyroid malignancy with local metastasis in 30%-50% of the cases and distant metastasis predominantly to lung, liver and skeleton in 13%-15% of patients. Identification of the lesion using imaging modalities is of crucial importance for disease management in the recurrent or metastatic MTC. In this study, we aimed to determine the efficacy of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) and gallium-68 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid tyrosine-3-octreotate (Ga-DOTATATE) PET/CT imaging in patients with MTC and to evaluate the relationship between imaging findings and serum tumor markers.
The records of MTC patients, who were treated and followed-up in our department between the years 2005 and 2018 were retrospectively analyzed. Seventy-three patients with MTC, who underwent either Ga-DOTATATE PET/CT (n=61) and/or F-FDG PET/CT (n=59) together with serum calcitonin (Ctn) and/or carcinoembryogenic antigen (CEA) measurement within 6 months period were included in the study. Gallium-68-DOTATATE PET/CT and F-FDG PET/CT scans performed within 6 months on the same patient (n=38) were analyzed separately for comparison of the efficacy of both modalities.
The overall sensitivity of F-FDG PET/CT and Ga-DOTATATE PET/CT were 72.4% and 88.1%, respectively in detecting recurrent or metastatic disease. In the group of patients, who had both F-FDG PET/CT and Ga-DOTATATE PET/CT within 6 months interval (median: 1.14 months; range: 0.03 - 5.7 months), no significant difference was found in the overall sensitivity of both imaging modalities, however Ga-DOTATATE PET/CT was found to be more sensitive in detection of bone lesions compared to F-FDG PET/CT (P=0.005).
Both F-FDG PET/CT and Ga-DOTATATE PET/CT are efficient imaging modalities in detection of recurrent or metastatic disease in MTC patients. Gallium-68-DOTATATE PET/CT could be more beneficial in detection of bone metastases with respect to F-FDG PET/CT.
甲状腺髓样癌（MTC）是一种侵袭性甲状腺恶性肿瘤，30%-50%的病例存在局部转移，13%-15%的患者存在远处转移，主要转移至肺、肝和骨骼。使用成像方式识别病变对于复发性或转移性 MTC 的疾病管理至关重要。在这项研究中，我们旨在确定氟-18-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）和镓-68 1,4,7,10-四氮环十二烷-1,4,7,10-四乙酸酪氨酸-3-奥曲肽（Ga-DOTATATE）PET/CT 成像在 MTC 患者中的疗效，并评估成像结果与血清肿瘤标志物之间的关系。
回顾性分析了 2005 年至 2018 年间在我科治疗和随访的 MTC 患者的记录。将 73 例 MTC 患者纳入研究，这些患者在 6 个月内接受了 Ga-DOTATATE PET/CT（n=61）和/或 F-FDG PET/CT（n=59）检查，并同时测量降钙素（Ctn）和/或癌胚抗原（CEA）。对同一位患者在 6 个月内进行的 Ga-DOTATATE PET/CT 和 F-FDG PET/CT 扫描（n=38）进行了单独分析，以比较两种方法的疗效。
F-FDG PET/CT 和 Ga-DOTATATE PET/CT 检测复发性或转移性疾病的总体敏感性分别为 72.4%和 88.1%。在接受 F-FDG PET/CT 和 Ga-DOTATATE PET/CT 检查的患者中，两种成像方式的总体敏感性均无显著差异（中位数：1.14 个月；范围：0.03-5.7 个月），但 Ga-DOTATATE PET/CT 在检测骨病变方面比 F-FDG PET/CT 更敏感（P=0.005）。
F-FDG PET/CT 和 Ga-DOTATATE PET/CT 都是检测 MTC 患者复发性或转移性疾病的有效成像方式。与 F-FDG PET/CT 相比，镓-68-DOTATATE PET/CT 可能更有利于检测骨转移。
