title: 99mTc-EDDA/HYNIC-TOC in the management of medullary thyroid carcinoma.
abstract: An early diagnosis of distant metastases or local recurrences of medullary thyroid carcinoma (MTC) can be achieved by several conventional radiological modalities (e.g., ultrasonography, computed tomography [CT], and magnetic resonance imaging [MRI] as well as by radioisotopic procedures, such as positron emission tomography (PET), scintigraphy with different types of radiopharmaceuticals, and radiolabeled receptor-ligands in particular. The aim of this study was to evaluate the clinical utility of 99mTc-EDDA/HYNIC-TOC, a new octreotide derivative, to detect recurrences of disease or distant metastases in MTC. Images obtained of 5 patients with high levels of serum calcitonin were compared to findings obtained with other diagnostic procedures: 111In-octreotide, 99mTc-DMSA-V, 18F-flouro-D-deoxyglucose-PET, and CT/MRI. 99mTc-EDDA/HYNIC-TOC was positive in all patients and showed 15 areas of pathological uptake in the cervical and mediastinal regions. 111In-octreotide was positive in 3 of 3 patients and showed 4 areas, compared to 8 of 99mTc-EDDA/HYNIC-TOC. 99mTc-V-DMSA was positive in 3 of 4 patients but showed 6 pathological areas, compared to 13 of 99mTc-EDDA/HYNIC-TOC. 18F-FDG-PET was positive in 5 of 5 patients but showed only 11 areas, compared to 15 of 99mTc-EDDA/HYNIC-TOC. The CT scan was positive in only 2 patients. In conclusion, 99mTc-EDDA/HYNIC-TOC detected more sites of pathological uptake than other modalities, showed better imaging properties than 111In-octreotide, and might be the radiopharmaceutical of choice for providing a rationale for radioisotopic therapy.
authors.affiliation: Nuclear Medicine and Internal Medicine, Department of Clinical Sciences, University La Sapienza, Rome, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Parisella
authors.forename: Calogero
authors.initials: C
authors.lastname: D'Alessandria
authors.forename: Bieke
authors.initials: B
authors.lastname: van de Bossche
authors.forename: Marco
authors.initials: M
authors.lastname: Chianelli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ronga
authors.forename: Enrico
authors.initials: E
authors.lastname: Papini
authors.forename: Renata
authors.initials: R
authors.lastname: Mikolajczak
authors.forename: Claudio
authors.initials: C
authors.lastname: Letizia
authors.forename: Giorgio
authors.initials: G
authors.lastname: De Toma
authors.forename: Augusto
authors.initials: A
authors.lastname: Veneziani
authors.forename: Francesco
authors.initials: F
authors.lastname: Scopinaro
authors.forename: Alberto
authors.initials: A
authors.lastname: Signore
mesh_terms: D000368:Aged; D018276:Carcinoma, Medullary / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds / Q000627:therapeutic use*; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000628:therapy*
chemical_list: D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C487389:technetium 99m EDDA-HYNIC-Tyr(3)-octreotide