RT Journal Article
SR Electronic
T1 Complementary Roles of <sup>18</sup>F-DOPA PET/CT and <sup>18</sup>F-FDG PET/CT in Medullary Thyroid Cancer
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1855
OP 1863
DO 10.2967/jnumed.111.094771
VO 52
IS 12
A1 Saila Kauhanen
A1 Camilla Schalin-Jäntti
A1 Marko Seppänen
A1 Sami Kajander
A1 Sami Virtanen
A1 Jukka Schildt
A1 Irina Lisinen
A1 Aapo Ahonen
A1 Ilkka Heiskanen
A1 Mika Väisänen
A1 Johanna Arola
A1 Pirkko Korsoff
A1 Tapani Ebeling
A1 Timo Sane
A1 Heikki Minn
A1 Matti J. Välimäki
A1 Pirjo Nuutila
YR 2011
UL http://jnm.snmjournals.org/content/52/12/1855.abstract
AB Serum calcitonin and carcinoembryonic antigen (CEA) are markers of recurrent or persistent disease in medullary thyroid cancer (MTC). However, conventional imaging often fails to localize metastatic disease. Our aim was to compare fluorine-labeled dihydroxyphenylalanine (18F-DOPA) and 18F-FDG PET/CT with multidetector CT (MDCT) and MRI in recurrent or persistent MTC. Methods: Nineteen MTC patients with increased calcitonin or CEA on follow-up (mean ± SD, 93 ± 91 mo; range, 4–300 mo) after primary therapy were prospectively imaged with 4 techniques: 18F-DOPA PET/CT, 18F-FDG PET/CT, MDCT, and MRI. Images were analyzed for pathologic lesions, which were surgically removed when possible. The correlation between the detection rate for each method and the calcitonin and CEA concentrations and histopathologic findings was investigated. Results: On the basis of histology and follow-up, one or more imaging methods accurately localized metastatic disease in 12 (63%) of 19 patients. The corresponding figures for 18F-DOPA PET/CT, 18F-FDG PET/CT, MDCT, and MRI were 11 (58%) of 19, 10 (53%) of 19, 9 (47%) of 19, and 10 (59%) of 17, respectively. Calcitonin and CEA correlated with 18F-DOPA PET/CT (P = 0.0007 and P = 0.0263, respectively) and 18F-FDG PET/CT findings (both P &lt; 0.0001). In patients with an unstable calcitonin doubling time (n = 8), 18F-DOPA and 18F-FDG PET/CT were equally sensitive. In contrast, for patients with an unstable CEA doubling time (n = 4), 18F-FDG PET/CT was more accurate. Conclusion: For most MTC patients with occult disease, 18F-DOPA PET/CT accurately detects metastases. In patients with an unstable calcitonin level, 18F-DOPA PET/CT and 18F-FDG PET/CT are complementary. For patients with an unstable CEA doubling time, 18F-FDG PET/CT may be more feasible. MRI is sensitive but has the highest rate of false-positive results.