111In-pentetreotide scintigraphy in the post-thyroidectomy follow-up of patients with medullary thyroid carcinoma.
Local and lymphnodal recurrences of medullary thyroid carcinoma (MTC) in thyroidectomy patients with elevated plasma levels of calcitonin and/or CEA can be detected using 111In-pentetreotide (Octreoscan: OCT) scintigraphy, although the sensitivity of this technique in localizing an intrathyroid recurrence of tumor is affected by the low target/non-target uptake ratio. The survival rate of patients with MTC, who have undergone thyroidectomy and who show evidence of a rise in plasma levels of calcitonin and/or CEA is closely linked to the number and localization of the metastases. However the role of conventional imaging techniques (X-rays, US, CT, and MR) in the follow-up after thyroidectomy is controversial. Numerous radiocompounds are currently being used to detect local and distant recurrences of MTC. The present study evaluated OCT and pentavalent 99mTc-dimercapto-succinic-acid (99mTc-DMSA-V) scintigraphy performed in 13 patients with a histologic diagnosis of MTC and in one with MEN 2A, all of whom had undergone thyroidectomy between 3 months and 15 years before. The patients also underwent 123I (NaCI) scintigraphy to evaluate the sites and extension of thyroidal remnants. 111In-pentetreotide scintigraphy was positive in 9/14 patients (64%); the 99mTc-DMSA-V was positive in 5/14 patients (35%). 111In-pentetreotide scintigraphy recognized 18 sites of abnormal uptake (12 in the neck); 9mmTc-DMSA-V detected 9 MTC recurrences in the same patients. In conclusion, 111In-OCT scintigraphy represents, in the authors' experience, a useful method, more sensitive than 9mmTc-DMSA-V, to detect MTC recurrences in patient follow-up post-thyroidectomy.
Celentano
L
L
Department of Nuclear Medicine, University Federico IL, Naples, Italy.
Sullo
P
P
Klain
M
M
Lupoli
G
G
Cascone
E
E
Salvatore
M
M
D000328:Adult; D000368:Aged; D002116:Calcitonin / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D018276:Carcinoma, Medullary / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D003952:Diagnostic Imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007205:Indium Radioisotopes; D007457:Iodine Radioisotopes; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D018813:Multiple Endocrine Neoplasia Type 2a / Q000000981:diagnostic imaging; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D013004:Somatostatin / Q000031:analogs & derivatives*; D004113:Succimer; D015996:Survival Rate; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D013965:Thyroidectomy
D002272:Carcinoembryonic Antigen; D007205:Indium Radioisotopes; D007457:Iodine Radioisotopes; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D013004:Somatostatin; D002116:Calcitonin; D004113:Succimer; C081788:pentetreotide