111In-pentetreotide scintigraphy in the post-thyroidectomy follow-up of patients with medullary thyroid carcinoma.

Abstract

Local and lymphnodal recurrences of medullary thyroid carcinoma (MTC) in thyroidectomy patients with elevated plasma levels of calcitonin and/or CEA can be detected using 111In-pentetreotide (Octreoscan: OCT) scintigraphy, although the sensitivity of this technique in localizing an intrathyroid recurrence of tumor is affected by the low target/non-target uptake ratio. The survival rate of patients with MTC, who have undergone thyroidectomy and who show evidence of a rise in plasma levels of calcitonin and/or CEA is closely linked to the number and localization of the metastases. However the role of conventional imaging techniques (X-rays, US, CT, and MR) in the follow-up after thyroidectomy is controversial. Numerous radiocompounds are currently being used to detect local and distant recurrences of MTC. The present study evaluated OCT and pentavalent 99mTc-dimercapto-succinic-acid (99mTc-DMSA-V) scintigraphy performed in 13 patients with a histologic diagnosis of MTC and in one with MEN 2A, all of whom had undergone thyroidectomy between 3 months and 15 years before. The patients also underwent 123I (NaCI) scintigraphy to evaluate the sites and extension of thyroidal remnants. 111In-pentetreotide scintigraphy was positive in 9/14 patients (64%); the 99mTc-DMSA-V was positive in 5/14 patients (35%). 111In-pentetreotide scintigraphy recognized 18 sites of abnormal uptake (12 in the neck); 9mmTc-DMSA-V detected 9 MTC recurrences in the same patients. In conclusion, 111In-OCT scintigraphy represents, in the authors' experience, a useful method, more sensitive than 9mmTc-DMSA-V, to detect MTC recurrences in patient follow-up post-thyroidectomy.

• Authors: L Celentano, P Sullo, M Klain, G Lupoli, E Cascone, M Salvatore
• Journal: The quarterly journal of nuclear medicine : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR) (Q J Nucl Med) Vol. 39 Issue 4 Suppl 1 Pg. 131-3 (Dec 1995) ISSN: 1125-0135 [Print] Italy
• PMID: 9002771 (Publication Type: Journal Article)

Chemical References

• Carcinoembryonic Antigen
• Indium Radioisotopes
• Iodine Radioisotopes
• Organotechnetium Compounds
• Radiopharmaceuticals
• Technetium Tc 99m Dimercaptosuccinic Acid
• Somatostatin
• Calcitonin
• Succimer
• pentetreotide

Topics

• Adult
• Aged
• Calcitonin (blood)
• Carcinoembryonic Antigen (blood)
• Carcinoma, Medullary (diagnostic imaging, secondary, surgery)
• Diagnostic Imaging
• Female
• Follow-Up Studies
• Humans
• Indium Radioisotopes
• Iodine Radioisotopes
• Lymphatic Metastasis (diagnostic imaging)
• Male
• Middle Aged
• Multiple Endocrine Neoplasia Type 2a (diagnostic imaging)
• Neoplasm Recurrence, Local (diagnostic imaging)
• Organotechnetium Compounds
• Radionuclide Imaging
• Radiopharmaceuticals
• Sensitivity and Specificity
• Somatostatin (analogs & derivatives)
• Succimer
• Survival Rate
• Technetium Tc 99m Dimercaptosuccinic Acid
• Thyroid Neoplasms (diagnostic imaging, surgery)
• Thyroidectomy