Rubello D et al. - In a study to assess the diagnostic role of 18F-FDG PET/CT performed with a hybrid tomograph in the detection of tumoral deposits of recurrent medullary thyroid carcinoma (MTC), it was found that 18F-FDG PET/CT was the most sensitive imaging modality in detecting metastases in recurrent MTC pts with increased serum calcitonin levels and 18F-FDG PET/CT was useful in some pts to plan a more accurate re-operation. From a diagnostic view, a multimodality imaging approach is recommended in recurrent MTC, especially based on the combination of c.e. CT and 18F-FDG PET/CT Methods
19 MTC pts with elevated serum calcitonin levels after first treatment were enrolled
All pts had previously undergone total thyroidectomy and lymphoadenectomy
Pts were studied with ultrasound (US), 18F-FDG PET/CT, 111In-pentetreotide scan, and contrast-enhanced whole-body CT (c.e. CT)
In 4 pts with equivocal abdominal findings at 18F-FDG PET/CT and/or at c.e. CT, laparoscopy was also performed
Results
18F-FGD PET/CT depicted metastases in 15 pts, 111In-pentetreotide in 8, c.e. CT in 11, US in 6
In 2 pts, liver micrometastases were detected at laparoscopy only
At a lesion-by-lesion analysis, 18F-FDG PET/CT visualized a total of 26 metastatic deposits, c.e. CT 18, 111In-pentetreotide 12, US 8
Final diagnosis was obtained by cytological or surgical findings
4 pts with evidence of limited metastatic spread to neck/upper mediastinum were re-operated, and in 2 of them serum calcitonin levels normalized
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