Multimodal imaging with 18 F-FDG-PET/CT and 111 In-Octreotide SPECT in patients with metastatic medullary thyroid carcin
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ORIGINAL ARTICLE
Multimodal imaging with 18F-FDG-PET/CT and 111In-Octreotide SPECT in patients with metastatic medullary thyroid carcinoma Serena De Luca1 • Rosa Fonti2 • Luigi Camera1 • Barbara Salvatore2 • Antongiulio Faggiano3 • Andrea Ciarmiello4 • Sabrina Segreto1 • Annamaria Colao3 Marco Salvatore5 • Silvana Del Vecchio1,2
•
Received: 15 September 2015 / Accepted: 13 December 2015 Ó The Japanese Society of Nuclear Medicine 2016
Abstract Objective The aim of our study was to determine the role of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) and indium-111 Octreotide single photon emission tomography (111In-Octreotide SPECT) in the evaluation of metastatic medullary thyroid carcinoma (MMTC). Methods Twenty-five MMTC patients were retrospectively evaluated. All patients had undergone whole-body 18 F-FDG-PET/CT including 20 who had also undergone 111 In-Octreotide SPECT within a maximum interval of 6 weeks. Diagnostic contrast-enhanced computed tomography (CT) alone or as part of 18F-FDG-PET/CT examination was performed in all patients. Results Contrast-enhanced CT detected a total of 131 lesions including 79 enlarged lymph nodes and 14 bone lesions. 18F-FDG-PET/CT visualized a total of 92 true positive lesions (SUVmax range 1.1–10.0, mean 4.0 ± 1.7) including 66 lymph nodes, 7 of which were not enlarged on CT, and 8 bone metastases. In the 20 patients studied with both techniques, a total of 64 and 46 true positive lesions & Silvana Del Vecchio [email protected] 1
Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, Edificio 10, 80131 Naples, Italy
2
Institute of Biostructures and Bioimages, National Research Council, Naples, Italy
3
Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
4
Nuclear Medicine Department, Hospital S. Andrea, La Spezia, Italy
5
IRCCS-SDN, Naples, Italy
were detected by 18F-FDG-PET/CT and 111In-Octreotide SPECT, respectively. In particular, 18F-FDG uptake was found in 43 lymph nodes and in 7 bone metastases whereas 111 In-Octreotide uptake was detected in 27 lymph nodes and in 10 bone metastases. Conclusions In MMTC patients, 18F-FDG-PET/CT provides a useful contribution mainly in evaluating lymph node involvement whereas 111In-Octreotide SPECT can contribute to the detection and somatostatin receptor characterization especially of bone lesions. Keywords Medullary thyroid carcinoma 18F-FDG-PET/ CT 111In-Octreotide SPECT Contrast-enhanced CT Multimodal imaging
Introduction Medullary thyroid carcinoma (MTC) is a rare cancer arising from neural crest derived parafollicular C cells of the thyroid gland. It accounts for less than 5 % of all thyroid cancers and occurs in both a sporadic (80 %) and a familial form (20 %) [1, 2]. MTCs may have a variable biological behavior from indolent slow-growing tumors to highly aggressive types [2]. Almost all MTCs synthesize and secrete the polypeptide hormone calcitonin that serves as a biomarker of tu
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