title: Clinical value of technetium-99m-labeled octreotide scintigraphy in local recurrent or metastatic medullary thyroid cancers: a comparison of lesions with 18F-FDG-PET and MIBI images.
abstract: OBJECTIVE
  Various studies have been conducted for determining the most optimal method for the early diagnosis of local recurrent or distant metastatic thyroid cancers. The aim of this study was to evaluate the clinical utility of technetium-99m (Tc-99m)-labeled octreotide derivatives in the detection of recurrence or distant metastases in medullary thyroid cancer patients and to compare the lesions with those detected using 18F-fluorodeoxyglucose (18F-FDG)-PET and Tc-99m MIBI studies in the same patient group.
  
  
  METHODS
  Sixteen medullary thyroid cancer patients [two male and 14 female; mean age 52.0 ± 14.1 years (range 13-72 years)] were included in this study. All patients underwent a whole-body scan 1 and 4 h after injection with octreotide derivatives and single photon emission computed tomography images were taken of the sites suspicious for metastasis. The lesions seen in Tc-99m HYNIC octreotide studies were compared with those seen in 18F-FDG-PET and Tc-99m MIBI studies.
  
  
  RESULTS
  Among the Tc-99m-labeled octreotide scintigraphy studies, nine were evaluated as true positive (56.2%) and one was evaluated as false positive (6.2%); six were false negative (37.5%). In 16 patients, the total number of lesions seen on octreotide scintigraphy was 21. Thirteen of the 16 patients underwent 18F-FDG-PET imaging. Of the 13 patients studied, 10 showed true-positive (76.9%) and three showed false-negative (23.1%) results. The total number of lesions seen on 18F-FDG-PET was 23. The Tc-99m MIBI study yielded positive results in seven of 16 patients (43.7%) and negative results in nine patients (56.3%). The total number of lesions on Tc-99m MIBI was 12.
  
  
  CONCLUSIONS
  The Tc-99m-labeled somatostatin receptor scintigraphy analogs HYNIC-tyrosine octreotide and HYNIC-TATE are useful imaging alternatives in somatostatin receptor-expressing thyroid cancers. Radiolabeling using these analogs is easy and they are readily available for routine use.
authors.affiliation: aDepartment of Nuclear Medicine, Cerrahpasa Medical Faculty, Istanbul University bDepartment of Pediatrics, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey cDepartment of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany.
authors.forename: Sait
authors.initials: S
authors.lastname: Sager
authors.forename: Levent
authors.initials: L
authors.lastname: Kabasakal
authors.forename: Meltem
authors.initials: M
authors.lastname: Ocak
authors.forename: Helmut
authors.initials: H
authors.lastname: Maecke
authors.forename: Lebriz
authors.initials: L
authors.lastname: Uslu
authors.forename: Metin
authors.initials: M
authors.lastname: Halaç
authors.forename: Sertac
authors.initials: S
authors.lastname: Asa
authors.forename: Günes
authors.initials: G
authors.lastname: Sager
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; D018278:Carcinoma, Neuroendocrine; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D015282:Octreotide; D049268:Positron-Emission Tomography / Q000379:methods*; D017256:Technetium Tc 99m Sestamibi; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D055815:Young Adult
chemical_list: D019788:Fluorodeoxyglucose F18; D017256:Technetium Tc 99m Sestamibi; D015282:Octreotide