title: Pentavalent Tc-99m DMSA scintigraphy. Prospective evaluation of its role in the management of patients with medullary carcinoma of the thyroid.
abstract: Ten patients with suspected primary, recurrent or metastatic medullary carcinoma of the thyroid (MCT) were studied prospectively with Tc-99m(V) DMSA. Of these, two patients had primary disease, seven patients were asymptomatic but had persistent and serial elevations in serum calcitonin following previous thyroid resections for MCT, and one asymptomatic patient with normal serum calcitonin was studied because of suspected hilar nodes metastases. The serial calcitonin peak in the patients was 0.04-43ng/ml (normal less than 0.08ng/ml). Scintigraphy was considered positive in seven of the asymptomatic patients and equivocal in one. The two patients with primary disease had increased uptake before but not after thyroidectomy. Primary disease, localized recurrence and distant metastases in soft tissue (nine patients) and bone (one patient) were detected in these patients, and this resulted in early surgical resection (five patients) and radiotherapy (one patient). We conclude that Tc-99m(V) DMSA is a useful imaging agent in the evaluation of asymptomatic MCT patients with hypercalcitonemia.
authors.affiliation: University Department of Radiology, Radcliffe Infirmary, Oxford, United Kingdom.
authors.forename: O A
authors.initials: OA
authors.lastname: Mojiminiyi
authors.forename: R
authors.initials: R
authors.lastname: Udelsman
authors.forename: N D
authors.initials: ND
authors.lastname: Soper
authors.forename: B J
authors.initials: BJ
authors.lastname: Shepstone
authors.forename: N E
authors.initials: NE
authors.lastname: Dudley
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000556:secondary; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy; D015609:Organotechnetium Compounds; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000556:secondary; D004113:Succimer; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy
chemical_list: D015609:Organotechnetium Compounds; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D004113:Succimer