Nuclear medicine procedures in the diagnosis and therapy of medullary thyroid carcinoma.
Medullary thyroid carcinoma (MTC) is a rare neuroendocrine tumor originating in the parafollicular cells (C cells) of the thyroid and secretes both calcitonin and carcino-embryonic antigen (CEA). Genetic and biochemical testing allow early pre-clinical identification of familial forms. Sporadic MTC usually presents as a solitary thyroid nodule; the diagnosis can be made preoperatively by fine-needle aspiration or by calcitonin assay, though it is usually established at the time of surgery. In the diagnostic assessment of MTC, nuclear medicine imaging provides its contribution mainly in the post-operative work-up to detect residual/recurrent tumor. For such purpose a number of radiopharmaceuticals, which take advantage of the specific expression of receptors (the somatostatin analogue (111)In-octreotide), hormone transporters (radiolabelled MIBG) or molecular targets (radiolabelled anti-CEA monoclonal antibodies) by MTC lesions are available; these tracers may be used also for the palliative treatment of advanced MTC. Interesting perspectives for MTC imaging are offered by PET radiopharmaceuticals.
Rufini
Vittoria
V
Institute of Nuclear Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.
Castaldi
Paola
P
Treglia
Giorgio
G
Perotti
Germano
G
Gross
Milton D
MD
Al-Nahhas
Adil
A
Rubello
Domenico
D
D019797:3-Iodobenzylguanidine; D000818:Animals; D002272:Carcinoembryonic Antigen / Q000276:immunology; D018276:Carcinoma, Medullary / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D006801:Humans; D007457:Iodine Radioisotopes; D009683:Nuclear Medicine; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D013004:Somatostatin / Q000031:analogs & derivatives / Q000494:pharmacology; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D015899:Tomography, Emission-Computed, Single-Photon
D002272:Carcinoembryonic Antigen; D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine; D013004:Somatostatin