Comparison of Ga-68 PET/CT to Other Imaging Studies in Medullary Thyroid Cancer: Superiority in Detecting Bone Metastases

Autor(es):Mostrar menos -

Castroneves, Luciana Audi ^[1] ; Coura Filho, George ^[2] ; Costa de Freitas, Ricardo Miguel ^[3] ; Salles, Raphael ^[4] ; Moyses, Raquel Ajub ^[5] ; Mendoza Lopez, Rossana Veronica ^[6] ; Albergaria Pereira, Maria Adelaide ^[7] ; Tavares, Marcos Roberto ^[5] ; de Lima Jorge, Alexander Augusto ^[7] ; Buchpiguel, Carlos Alberto ^[2] ; Hoff, Ana Oliveira ^[1]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Fac Med, ICESP, Dept Endocrinol, BR-01246000 Sao Paulo - Brazil

^[2] Univ Sao Paulo, Fac Med, ICESP, Dept Med Nucl, BR-01246000 Sao Paulo - Brazil

^[3] Univ Sao Paulo, Fac Med, ICESP, Dept Radiol, BR-01246000 Sao Paulo - Brazil

^[4] Univ Sao Paulo, Fac Med, ICESP, Dept Patol, BR-01246000 Sao Paulo - Brazil

^[5] Univ Sao Paulo, Fac Med, Hosp Clin, Serv Cirurgia Cabeca & Pescoco, BR-05403010 Sao Paulo - Brazil

^[6] Univ Sao Paulo, Fac Med, ICESP, Ctr Invest Translac Oncol, BR-01246000 Sao Paulo - Brazil

^[7] Univ Sao Paulo, Fac Med, Hosp Clin, Dept Endocrinol, BR-05403010 Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM; v. 103, n. 9, p. 3250-3259, SEP 2018.
• Citações Web of Science: 4

Resumo

Context: Persistent disease after surgery is common in medullary thyroid cancer (MTC), requiring lifelong radiological surveillance. Staging workup includes imaging of neck, chest, abdomen, and bones. A study integrating all sites would be ideal. Despite the established use of gallium-68 (Ga-68) positron emission tomography (PET)/CT with somatostatin analogues in most neuroendocrine tumors, its efficacy is controversial in MTC. Objective: Evaluate the efficacy of Ga-68 PET/CT in detecting MTC lesions and evaluate tumor expression of somatostatin receptors (SSTRs) associated with Ga-68 PET/CT findings. Methods: Prospective study evaluating 30 patients with MTC {[}group 1 (n = 16), biochemical disease; group 2 (n = 14), metastatic disease]. Patients underwent Ga-68 PET/CT, bone scan, CT and ultrasound of the neck, CT of the chest, CT/MRI of the abdomen, and MRI of the spine. Ga-68 PET/CT findings were analyzed by disease site as positive or negative and as concordant or discordant with conventional studies. Sensitivity and specificity were calculated using pathological or cytological analysis or unequivocal identification by standard imaging studies. Immunohistochemical analysis of SSTRs was compared with Ga-68 PET/CT findings. Results: In both groups, Ga-68 PET/CT was inferior to currently used imaging studies except for bone scan. In group 2, Ga-68 PET/CT sensitivities were 56%, 57%, and 9% for detecting neck lymph nodes, lung metastases, and liver metastases, respectively, and 100% for bone metastases, superior to the bone scan (44%). Expression of SSTRs, observed in 44% of tumors, was not associated with Ga-68-DOTATATE uptake. Conclusions: Ga-68 PET/CT does not provide optimal whole-body imaging as a single procedure in patients with MTC. However, it is highly sensitive in detecting bone lesions and could be a substitute for a bone scan and MRI. (AU)

• Processo FAPESP: 13/03876-4 - Avaliação do uso do 68Ga-peptídeo análogo de somatostatina PET/CT como ferramenta diagnóstica em tumores neuroendócrinos e sua correlação com marcadores moleculares
• Beneficiário: Ana Amélia Fialho de Oliveira Hoff
• Modalidade de apoio: Auxílio à Pesquisa - Regular