title: Comparison of 99mTc-HYNIC-TOC and HYNIC-TATE octreotide scintigraphy with FDG PET and 99mTc-MIBI in local recurrent or distant metastatic thyroid cancers.
abstract: OBJECTIVE
  There have been various studies for early diagnosis of local recurrent or distant metastatic thyroid cancers. The aim of this study is to evaluate the clinical utility of 99mTc-HYNIC-TOC and 99mTc-HYNIC-TATE, octreotide derivatives, to detect recurrences or distant metastases in 131I-negative thyroglobulin positive thyroid cancer patients and to compare the lesions with FDG PET and 99mTc-MIBI studies in the same patient group.
  
  
  METHODS
  Twenty differentiated thyroid cancer patients, 7 male and 13 female, mean age 54.6 ± 15.3 (range 13-78 years), were included in this study. Eighteen patients had papillary thyroid cancer and 2 had follicular thyroid cancer. Fifteen patients received HYNIC-TOC and 5 patients received HYNIC-TATE as a radiopharmaceutical. All patients underwent whole-body scan 1 and 4 hours after injection of octreotide derivatives and SPECT imagings were performed from the suspicious sites. The lesions that were seen in 99mTc-HYNIC-TOC and 99mTc-HYNIC-TATE studies were compared with 99mTc-MIBI and FDG-PET studies.
  
  
  RESULTS
  Among 99mTc-HYNIC-TOC and 99mTc-HYNIC-TATE scintigraphies, 15 patient studies were evaluated as true positive (75%) and 5 were false negative (25%). The total number of lesions in octreotide scintigraphy was 48 in 20 patients. Of 20 patients, 19 had FDG-PET study, 15 of them were evaluated as true positive (78.9%), and 4 them were evaluated as false negative (21.1%). Total number of lesions in FDG PET was 74. 99mTc-MIBI study was positive in 11 patients (55%) and negative in 9 patients (45%). Total number of lesions in 99mTc-MIBI was 25.
  
  
  CONCLUSIONS
  Technetium-labeled somatostatin receptor scintigraphy analogues HYNIC-TOC and HYNIC-TATE are useful imaging alternatives in somatostatin receptor expressing thyroid cancer patients. Radiolabeling is easy and they are readily available for routine use.
authors.affiliation: Department of Nuclear Medicine, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey. saitsager@yahoo.com
authors.forename: Sait
authors.initials: S
authors.lastname: Sager
authors.forename: Levent
authors.initials: L
authors.lastname: Kabasakal
authors.forename: Metin
authors.initials: M
authors.lastname: Halac
authors.forename: Helmut
authors.initials: H
authors.lastname: Maecke
authors.forename: Lebriz
authors.initials: L
authors.lastname: Uslu
authors.forename: Çetin
authors.initials: Ç
authors.lastname: Önsel
authors.forename: Bedii
authors.initials: B
authors.lastname: Kanmaz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D015282:Octreotide / Q000031:analogs & derivatives*; D015609:Organotechnetium Compounds; D049268:Positron-Emission Tomography / Q000379:methods*; D011829:Radiation Dosage; D017256:Technetium Tc 99m Sestamibi; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D055815:Young Adult
chemical_list: D015609:Organotechnetium Compounds; C532019:technetium Tc 99m hydrazinonicotinyl-Tyr(3)-Thr(8)-octreotide; C410263:technetium Tc 99m hydrazinonicotinyl-Tyr(3)-octreotide; D019788:Fluorodeoxyglucose F18; D017256:Technetium Tc 99m Sestamibi; D015282:Octreotide