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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 6/2016

01-06-2016 | Original Article

18F-DOPA PET/CT in the diagnosis and localization of persistent medullary thyroid carcinoma

Authors: Aurélien Archier, Céline Heimburger, Carole Guerin, Isabelle Morange, Fausto F Palazzo, Jean-François Henry, Olivier Schneegans, Olivier Mundler, Ahmad Esmaeel Abdullah, Frédéric Sebag, Alessio Imperiale, David Taïeb

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 6/2016

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Abstract

Purpose

To evaluate the performance of 18F-l-dihydroxyphenylalanine (18F-DOPA) PET/CT in the detection of locoregional and distant medullary thyroid carcinoma (MTC) metastases and to compare imaging findings with histological data.

Methods

We retrospectively evaluated 86 MTC patients with persistently high serum calcitonin levels after initial surgery who had undergone 18F-DOPA PET/CT between January 2007 and December 2014 in two referral centres. They were followed up for at least 6 months after the PET/CT assessment. The results were compared with histological data or with the findings obtained during follow-up using a complementary imaging modality.

Results

18F-DOPA PET/CT was positive in 65 of the 86 patients, corresponding to a patient-based sensitivity of 75.6 %. Distant metastatic disease (M1) was seen in 29 patients including 11 with previously unknown metastases revealed only by PET/CT. Among the 36 patients without distant metastatic spread, 25 had nodal involvement limited to the neck, and 10 of these 25 patients underwent reoperation. The lymph node compartment-based sensitivity of 18F-DOPA PET/CT was 100 % in the two institutions but lesion-based sensitivity was only 24 %. Preoperative and postoperative median calcitonin levels were 405 pg/mL (range 128 – 1,960 pg/mL) and 259 pg/mL (range 33 – 1,516 pg/mL), respectively. None of the patients achieved normalization of serum calcitonin after reoperation.

Conclusion

18F-DOPA PET/CT enables early diagnosis of a significant number of patients with distant metastasis. It has a limited sensitivity in the detection of residual disease but provides high performance for regional analysis. A surgical compartment-oriented approach could be the approach of choice whatever the number of nodes revealed by 18F-DOPA PET/CT.
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Metadata
Title
18F-DOPA PET/CT in the diagnosis and localization of persistent medullary thyroid carcinoma
Authors
Aurélien Archier
Céline Heimburger
Carole Guerin
Isabelle Morange
Fausto F Palazzo
Jean-François Henry
Olivier Schneegans
Olivier Mundler
Ahmad Esmaeel Abdullah
Frédéric Sebag
Alessio Imperiale
David Taïeb
Publication date
01-06-2016
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 6/2016
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-015-3227-y

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