Somatostatin and somatostatin analogues in medullary thyroid carcinoma.
Medullary thyroid carcinoma (MTC) is a neuroendocrine tumour characterized by the production and secretion of calcitonin. MTC tumours may express functional somatostatin receptors (hSSTR). A significant proportion of hSSTR receptor-positive MTC tumours, including metastatic disease, may be visualized in vivo through 111In-pentetreotide scintigraphy. Four patients with recurrent/metastatic disease, who had previously been assessed with 111In-anti-CEA monoclonal antibody fragment [F(ab')2] imaging, were evaluated. 111In-pentetreotide scintigraphy localized all known disease sites. Furthermore, mediastinal disease was detected in one patient with negative conventional, and 111In-anti-CEA F(ab')2 imaging studies. The detection of somatostatin within the tumour (2 patients), or negative octreotide challenges (2 patients), did not affect the outcome of 111In-pentetreotide scintigraphy. In conclusion, 111In-pentetreotide scintigraphy appears at least as effective as 111In-anti-CEA F(ab')2 imaging and should be considered in the diagnostic evaluation of MTC, particularly in the setting of recurrent/metastatic disease not detected by conventional means.
Department of Endocrinology, St James's Hospital, Dublin, Ireland.
K J
KJ
O'Byrne
N
N
O'Hare
E
E
Sweeney
P J
PJ
Freyne
M J
MJ
Cullen
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal; D002116:Calcitonin / Q000378:metabolism; D002272:Carcinoembryonic Antigen / Q000378:metabolism; D018276:Carcinoma, Medullary / Q000000981:diagnostic imaging* / Q000378:metabolism* / Q000556:secondary; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments; D007205:Indium Radioisotopes; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D016719:Radioimmunodetection; D017481:Receptors, Somatostatin / Q000378:metabolism; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000378:metabolism*; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism*
D000911:Antibodies, Monoclonal; D002272:Carcinoembryonic Antigen; D007140:Immunoglobulin Fab Fragments; D007205:Indium Radioisotopes; D017481:Receptors, Somatostatin; D013004:Somatostatin; D002116:Calcitonin; C081788:pentetreotide