title: 18F-FDG PET, somatostatin receptor scintigraphy, and CT in metastatic medullary thyroid carcinoma: a clinical study and an analysis of the literature.
abstract: OBJECTIVE
  To determine the clinical potential of 2-[F]fluoro-2-deoxy-D-glucose positron emission tomography (F-FDG PET) in patients with medullary thyroid carcinoma (MTC), we compared it to computed tomography (CT), and somatostatin receptor scintigraphy (SRS).
  
  
  METHODS
  Blinded evaluation of PET, CT and SRS images obtained from 26 patients with histologically proven metastatic MTC was done by nuclear medicine and radiology specialists. Sites of tumour involvement were classified as "sure" or "suspicious". The data were analysed in comparison to two different standards. Either those sites classified as "sure" by at least one of the methods were defined as the standard or those sites of involvement which were classified as "sure" by at least two methods.
  
  
  RESULTS
  Dependent on the type of data analysis performed, PET was able to demonstrate 56.8%/80.6% of the tumour sites, CT showed 64.5%/79.6%, and SRS showed 47.5%/69.9% of the tumour sites.
  
  
  CONCLUSIONS
  Overall, CT is similar or better than PET in our patients (dependent on the standard) while SRS is inferior to both other techniques. Our data are in agreement with publications that consider CT superior to PET in the diagnosis of metastatic MTC while other studies show superiority of PET. However, a combination of CT and PET seems to be the most appropriate non-invasive diagnostic approach in patients with MTC.
authors.affiliation: Department of Nuclear Medicine, Philipps-University of Marburg, Baldingerstrasse, 35043 Marburg, Germany. gotthardt@mailer.uni-marburg.de
authors.forename: Martin
authors.initials: M
authors.lastname: Gotthardt
authors.forename: Anke
authors.initials: A
authors.lastname: Battmann
authors.forename: Helmut
authors.initials: H
authors.lastname: Höffken
authors.forename: Tino
authors.initials: T
authors.lastname: Schurrat
authors.forename: Halina
authors.initials: H
authors.lastname: Pollum
authors.forename: Daniela
authors.initials: D
authors.lastname: Beuter
authors.forename: Stefan
authors.initials: S
authors.lastname: Gratz
authors.forename: Martin
authors.initials: M
authors.lastname: Béhé
authors.forename: Artur
authors.initials: A
authors.lastname: Bauhofer
authors.forename: Klaus J
authors.initials: KJ
authors.lastname: Klose
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Behr
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018276:Carcinoma, Medullary / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000556:secondary; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D017481:Receptors, Somatostatin / Q000378:metabolism*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000556:secondary; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals; D017481:Receptors, Somatostatin; D019788:Fluorodeoxyglucose F18