FDG PET/CT versus somatostatin receptor PET/CT in TENIS syndrome: a systematic review and meta-analysis
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META-ANALYSIS
FDG PET/CT versus somatostatin receptor PET/CT in TENIS syndrome: a systematic review and meta‑analysis Felipe Alves Mourato1 · Maria Amorim Almeida1 · Ana Emília Teixeira Brito1 · Aline Lopes Garcia Leal1 · Paulo Almeida Filho1 · Elba Etchebehere2 Received: 12 August 2020 / Accepted: 11 September 2020 / Published online: 24 September 2020 © Italian Association of Nuclear Medicine and Molecular Imaging 2020
Abstract Purpose In patients with TENIS syndrome (Thyroglobulin-Elevated Negative Iodine Scintigraphy), PET/CT radiotracers, such FDG PET/CT and somatostatin analogs (SSTR PET/CT), can identify disease localization. Therefore, the objective of this paper is to compare the capability of identifying lesions in TENIS Syndrome using FDG PET/CT and SSTR PET/CT through a systematic review and meta-analysis. Methodology A literature search was performed in electronic databases until February 2020 to identify relevant studies on FDG and 68 Ga-somatostatin analogs tracers in patients with TENIS Syndrome. Results A total of 3551 abstracts reviewed from electronic databases and bibliographic references identified 13 candidates for the full-text analysis, and six articles were included in the qualitative and quantitative analyses. A total of 179 patients submitted to both SSTR PET/CT and FDG PET/CT to evaluate the performance of these radiotracers were analyzed. FDG PET/CT images identified significantly (p = 0.006) more patients with metastases when compared to SSTR PET/CT (143 vs. 103, respectively). Even though FDG PET/CT outperformed SSTR PET/CT, SSTR PET/CT was able to detect metastases in approximately 16% of FDG PET/CT negative cases. Conclusion FDG PET/CT has a higher capability to detect metastases than SSTR PET/CT in patients with TENIS Syndrome. Keywords Receptors · Somatostatin · Fluorodeoxyglucose · Thyroid neoplasms · Positron-emission tomography · Metaanalysis
Introduction Differentiated thyroid cancer (DTC) is the most common endocrine malignancy [1, 2] and presents with excellent prognosis after total thyroidectomy and radioiodine Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40336-020-00390-0) contains supplementary material, which is available to authorized users.
treatment in most cases [3, 4]. Even so, 20% of patients with DTC will develop locoregional recurrence, and 10% will develop distant metastases [5]. Typically, a rise in serum thyroglobulin (Tg) levels identifies such cases. Radioiodine (131I or 123I) whole-body scintigraphy (RAIWBS) and neck ultrasonography are performed to identify recurrence and metastases and to guide therapy. However, 15–20% of recurrent DTC become dedifferentiated [6–8].
* Elba Etchebehere [email protected]
Paulo Almeida Filho [email protected]
Felipe Alves Mourato [email protected]
1
Real Hospital Português de Beneficência em Pernambuco, Real Nuclear, Avenida Portugal, no. 163, Paissandu, Recife, PE 52010‑010, Brazil
2
Division of Nuclear Medicin
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