Background and Objective: In patients with postoperative persistent medullary thyroid cancer (MTC), the tumor detection rate is generally low for most of the imaging techniques now available. The aim of this study was to investigate if the the clinico-biological profile of the tumor may indicate which imaging technique to perform in order to identify postoperative persistent or relapsing MTC foci. Patients and Methods: Thirty-five consecutive MTC patients with detectable and progressively increasing postoperative serum concentrations of calcitonin were enrolled in the study. The detection rates of 18F-deoxy-D-glucose (FDG)-positron emission tomography (PET), somatostatin receptor scintigraphy (SRS) and 131I-metaiodobenzylguanidine scintigraphy (MIBG) were compared in relation with calcitonin and carcinoembryonic antigen serum concentrations, Ki-67 score and results of conventional imaging techniques (CIT). Results: FDG-PET positivity was significantly associated with calcitonin serum concentrations >400 pg/ml and Ki-67 score >2.0% (p<0.05), while SRS positivity was associated with calcitonin serum concentrations >800 pg/ml (p<0.05). SRS positivity significantly correlated with tumor appearance at CIT (p<0.01), while FDG-PET was positive in 9 CIT-negative patients. Conclusion: The secretive and proliferative tumor profile may guide the choice of the imaging technique to use in the follow-up of patients with MTC. A Ki-67 score >2.0% suggests to perform a FDG-PET in addition to conventional imaging. Calcitonin secretion predicts both FDG-PET and SRS uptake but SRS positivity is generally found only in patients with well defined MTC lesions which are also detectable at the conventional imaging examination. MIBG outcome is not predicted by any clinico-biological factors here investigated.

Secretive and proliferative tumor profile helps to select the best imaging technique to identify postoperative persistent or relapsing medullary thyroid cancer / Faggiano, Antongiulio; F., Grimaldi; L., Pezzullo; M. G., Chiofalo; C., Caracò; N., Mozzillo; A., Angeletti; F., Santeusanio; Lombardi, Gaetano; Colao, Annamaria; N., Avenia; P., Ferolla. - In: ENDOCRINE-RELATED CANCER. - ISSN 1351-0088. - ELETTRONICO. - Nov 12. [Epub ahead of print]:(2008), pp. 225-231.

Secretive and proliferative tumor profile helps to select the best imaging technique to identify postoperative persistent or relapsing medullary thyroid cancer

FAGGIANO, ANTONGIULIO;LOMBARDI, GAETANO;COLAO, ANNAMARIA;
2008

Abstract

Background and Objective: In patients with postoperative persistent medullary thyroid cancer (MTC), the tumor detection rate is generally low for most of the imaging techniques now available. The aim of this study was to investigate if the the clinico-biological profile of the tumor may indicate which imaging technique to perform in order to identify postoperative persistent or relapsing MTC foci. Patients and Methods: Thirty-five consecutive MTC patients with detectable and progressively increasing postoperative serum concentrations of calcitonin were enrolled in the study. The detection rates of 18F-deoxy-D-glucose (FDG)-positron emission tomography (PET), somatostatin receptor scintigraphy (SRS) and 131I-metaiodobenzylguanidine scintigraphy (MIBG) were compared in relation with calcitonin and carcinoembryonic antigen serum concentrations, Ki-67 score and results of conventional imaging techniques (CIT). Results: FDG-PET positivity was significantly associated with calcitonin serum concentrations >400 pg/ml and Ki-67 score >2.0% (p<0.05), while SRS positivity was associated with calcitonin serum concentrations >800 pg/ml (p<0.05). SRS positivity significantly correlated with tumor appearance at CIT (p<0.01), while FDG-PET was positive in 9 CIT-negative patients. Conclusion: The secretive and proliferative tumor profile may guide the choice of the imaging technique to use in the follow-up of patients with MTC. A Ki-67 score >2.0% suggests to perform a FDG-PET in addition to conventional imaging. Calcitonin secretion predicts both FDG-PET and SRS uptake but SRS positivity is generally found only in patients with well defined MTC lesions which are also detectable at the conventional imaging examination. MIBG outcome is not predicted by any clinico-biological factors here investigated.
2008
Secretive and proliferative tumor profile helps to select the best imaging technique to identify postoperative persistent or relapsing medullary thyroid cancer / Faggiano, Antongiulio; F., Grimaldi; L., Pezzullo; M. G., Chiofalo; C., Caracò; N., Mozzillo; A., Angeletti; F., Santeusanio; Lombardi, Gaetano; Colao, Annamaria; N., Avenia; P., Ferolla. - In: ENDOCRINE-RELATED CANCER. - ISSN 1351-0088. - ELETTRONICO. - Nov 12. [Epub ahead of print]:(2008), pp. 225-231.
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/338320
Citazioni
  • ???jsp.display-item.citation.pmc??? 5
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
social impact