alexa Comparison of 18F-DOPA, 18F-FDG and 68Ga-somatostatin analogue PET CT in patients with recurrent medullary thyroid carcinoma.
Oncology

Oncology

Journal of Nuclear Medicine & Radiation Therapy

Author(s): Treglia G, Castaldi P, Villani MF, Perotti G, de Waure C,

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Abstract PURPOSE: To retrospectively evaluate and compare (18)F-FDG, (18)F-DOPA and (68)Ga-somatostatin analogues for PET/CT in patients with residual/recurrent medullary thyroid carcinoma (MTC) suspected on the basis of elevated serum calcitonin levels. METHODS: Included in the study were 18 patients with recurrent MTC in whom functional imaging with the three tracers was performed. The PET/CT results were compared on a per-patient basis and on a per-lesion-basis. RESULTS: At least one focus of abnormal uptake was observed on PET/CT in 13 patients with (18)F-DOPA (72.2\% sensitivity), in 6 patients with (68)Ga-somatostatin analogues (33.3\%) and in 3 patients with (18)F-FDG (16.7\%) (p < 0.01). There was a statistically significant difference in sensitivity between (18)F-DOPA and (18)F-FDG PET/CT (p < 0.01) and between (18)F-DOPA and (68)Ga-somatostatin analogue PET/CT (p = 0.04). Overall, 72 lesions were identified on PET/CT with the three tracers. (18)F-DOPA PET/CT detected 85\% of lesions (61 of 72), (68)Ga-somatostatin analogue PET/CT 20\% (14 of 72) and (18)F-FDG PET/CT 28\% (20 of 72). There was a statistically significant difference in the number of lymph node, liver and bone lesions detected with the three tracers (p < 0.01). In particular, post-hoc tests showed a significant difference in the number of lymph node, liver and bone lesions detected by (18)F-DOPA PET/CT and (18)F-FDG PET/CT (p < 0.01 for all the analyses) and by (18)F-DOPA PET/CT and (68)Ga-somatostatin analogue PET/CT (p < 0.01 for all the analyses). The PET/CT results led to a change in management of eight patients (44\%). CONCLUSION: (18)F-DOPA PET/CT seems to be the most useful imaging method for detecting recurrent MTC lesions in patients with elevated serum calcitonin levels, performing better than (18)F-FDG and (68)Ga-somatostatin analogue PET/CT. (18)F-FDG may complement (18)F-DOPA in patients with an aggressive tumour. This article was published in Eur J Nucl Med Mol Imaging and referenced in Journal of Nuclear Medicine & Radiation Therapy

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