title: (111)In-octreotide scintigraphy for identification of metastatic medullary thyroid carcinoma in children and adolescents.
abstract: BACKGROUND
  Most medullary thyroid cancers (MTC) express somatostatin receptors; therefore, (111)In-octreotide somatostatin receptor scintigraphy (SRS) may be useful in detecting sites of metastases in children with MTC.
  
  
  OBJECTIVE
  The aim of the study was to evaluate tumor metastases in children and adolescents with MTC using SRS in comparison to conventional imaging.
  
  
  METHODS
  A case series was conducted as part of baseline evaluation for cancer treatment protocol at the National Institutes of Health Clinical Center.
  
  
  METHODS
  Eleven patients with a median age of 15 (range, 9-17) yr participated in the study, 10 with histologically proven, metastatic MTC due to the M918T mutation of the RET protooncogene, and one with a known RET polymorphism.
  
  
  METHODS
  After receiving 0.086 mCi/kg (111)Indium-pentreotide, patients were examined with a single photon emission computed tomography scan 4 and 24 h after injection. Baseline conventional imaging, including computed tomography (neck, chest, abdomen, ± pelvis, adrenals), magnetic resonance imaging (neck), and bone scan, was performed on all patients.
  
  
  METHODS
  SRS results were compared with conventional imaging.
  
  
  RESULTS
  Five of the 11 patients had abnormal findings on SRS. Of the 53 total target lesions present in the patients, only 24.5% were accurately identified through SRS.
  
  
  CONCLUSIONS
  SRS appears to be less sensitive than conventional imaging at detecting the full extent of metastatic disease in children and adolescents with hereditary MTC. SRS incompletely identified sites of tumor and failed to visualize small sites of tumor or liver and lung metastases, and it has a limited role in the evaluation of metastatic disease in pediatric MTC patients.
authors.affiliation: Section on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892, USA. lodishma@mail.nih.gov
authors.forename: Maya
authors.initials: M
authors.lastname: Lodish
authors.forename: Urania
authors.initials: U
authors.lastname: Dagalakis
authors.forename: Clara C
authors.initials: CC
authors.lastname: Chen
authors.forename: Ninet
authors.initials: N
authors.lastname: Sinaii
authors.forename: Patricia
authors.initials: P
authors.lastname: Whitcomb
authors.forename: Alberta
authors.initials: A
authors.lastname: Aikin
authors.forename: Eva
authors.initials: E
authors.lastname: Dombi
authors.forename: Leigh
authors.initials: L
authors.lastname: Marcus
authors.forename: Brigitte
authors.initials: B
authors.lastname: Widemann
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Fox
authors.forename: Meredith
authors.initials: M
authors.lastname: Chuk
authors.forename: Frank
authors.initials: F
authors.lastname: Balis
authors.forename: Samuel
authors.initials: S
authors.lastname: Wells
authors.forename: Constantine A
authors.initials: CA
authors.lastname: Stratakis
mesh_terms: D000293:Adolescent; D014408:Biomarkers, Tumor / Q000032:analysis / Q000097:blood; D018278:Carcinoma, Neuroendocrine; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D015282:Octreotide / Q000031:analogs & derivatives*; D017481:Receptors, Somatostatin / Q000378:metabolism; D013964:Thyroid Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D014055:Tomography, Emission-Computed / Q000379:methods; D047368:Tumor Burden; D051598:Whole Body Imaging
chemical_list: D014408:Biomarkers, Tumor; D017481:Receptors, Somatostatin; C094279:indium-111-octreotide; D015282:Octreotide