title: Metabolic response demonstrated by 18F-FDG-PET/CT in metastatic medullary thyroid carcinoma under sorafenib therapy.
abstract: A 51-year-old woman with a medullary thyroid carcinoma (MTC) presented with a palpable nodule in the right breast. Serum calcitonin was 1,453 pg/ml and carcinoembryonic antigen was 201 ng/ml. Cervical ultrasound and bone scintigraphy were normal. Computed tomography (CT) showed nodules in the right breast and anterior thoracic wall and a hypodense lesion in the right hepatic lobe. Histology of the breast nodule confirmed metastasis from MTC. To evaluate the metabolic activity of these lesions, 18F-fluorodeoxiglucose positron emission tomography-CT (FDG-PET/CT) scan was requested. Axial fused images revealed high FDG uptake by the breast and thoracic wall nodules and the right hepatic lobe. FDG-PET/CT also showed uptake in sacrum and right iliac bone, undetected by CT and bone scintigraphy. After seven cycles of sorafenib PET/CT became negative. Calcitonin decreased to 82.5. A PET/CT performed 6 months later remained negative. This is the first published image of the complete metabolic response of MTC to sorafenib therapy using FDG-PET/CT.
authors.affiliation: Nuclear Medicine Department, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Avda. Valdecilla, s/n, 39008, Santander, Spain. mimartinez@humv.es
authors.forename: I
authors.initials: I
authors.lastname: Martínez-Rodríguez
authors.forename: I
authors.initials: I
authors.lastname: Banzo
authors.forename: J M
authors.initials: JM
authors.lastname: Carril
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D054316:Biomarkers, Pharmacological / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000378:metabolism; D018278:Carcinoma, Neuroendocrine; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D009536:Niacinamide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use*; D049268:Positron-Emission Tomography; D000077157:Sorafenib; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D054316:Biomarkers, Pharmacological; D014408:Biomarkers, Tumor; D010671:Phenylurea Compounds; D019788:Fluorodeoxyglucose F18; D009536:Niacinamide; D000077157:Sorafenib
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