Somatostatin receptor imaging in persistent medullary thyroid carcinoma.
OBJECTIVE
Somatostatin is secreted from thyroid C-cells and seems to play an important part in the regulation of calcitonin secretion. We therefore evaluated the usefulness of somatostatin receptor scintigraphy in the localization of tumour tissue in patients with persistent medullary thyroid carcinoma.


METHODS
A prospective clinical study.


METHODS
The series consisted of 26 patients with elevated calcitonin levels after total thyroidectomy for histologically proven medullary thyroid carcinoma.


METHODS
Somatostatin receptor scintigraphy using 111In-pentetreotide (Octreoscan) was performed in all patients and the results correlated with histology, ultrasonography, computerized tomography, magnetic resonance imaging, plain radiography, bone scintigraphy and selective venous catheterization. Calcitonin and carcinoembryonic antigen levels were measured.


RESULTS
The sensitivity of somatostatin receptor scintigraphy for localization of persistent medullary thyroid carcinoma was 57% in patients with histologically proven disease. The results depended on tumour mass (low sensitivity (33%) in minimal residual disease) and on the location of metastases (insensitive in detecting liver metastases).


CONCLUSIONS
Somatostatin receptor scintigraphy is of value as an additional diagnostic tool in localizing medullary thyroid carcinoma, especially pulmonary metastases. It is of minor importance in detecting minimal residual disease.
Frank-Raue
K
K
Department of Internal Medicine, Endocrinology and Surgery, University of Heidelberg, Germany.
Bihl
H
H
Dörr
U
U
Buhr
H
H
Ziegler
R
R
Raue
F
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D002116:Calcitonin / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D018276:Carcinoma, Medullary / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007205:Indium Radioisotopes; D008113:Liver Neoplasms / Q000556:secondary; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D011446:Prospective Studies; D011877:Radionuclide Imaging; D017481:Receptors, Somatostatin / Q000032:analysis*; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000601:surgery; D013965:Thyroidectomy
D002272:Carcinoembryonic Antigen; D007205:Indium Radioisotopes; D017481:Receptors, Somatostatin; D002116:Calcitonin