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Somatostatin receptor scintigraphy using 99mTc-EDDA/HYNIC-TOC in patients with medullary thyroid carcinoma

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Abstract

Purpose

Several new somatostatin analogues have been developed for the diagnosis and therapy of different tumours. Since somatostatin receptors are often over-expressed in medullary thyroid carcinoma (MTC), the aim of our study was to evaluate the utility of scintigraphy with the somatostatin analogue 99mTc-EDDA/HYNIC-TOC in MTC in comparison with other diagnostic techniques.

Methods

Forty-five patients with MTC, aged 14–83 years, were investigated. Scintigraphy using 99mTc-EDDA/HYNIC-TOC (Tektrotyd) was performed 2 and 4 h post injection of 740 MBq (20 mCi) of the tracer. Other imaging techniques were also applied and analysed in individual cases (ultrasonography, computed tomography, 99mTc(V)-DMSA, 131I-MIBG, 99mTc-MDP, 111In-DTPA-octreotide and 18F-FDG-PET) and compared with 99mTc-EDDA/HYNIC-TOC.

Results

In group 1 (eight patients before thyroidectomy), uptake of the tracer was found in the primary tumours. In group 2 (six patients with remission), a false positive result was found in one patient; in the remaining five patients, no pathological foci were visualised. In group 3 (31 patients with post-surgical hypercalcitoninaemia), scintigraphy was true positive in 23 patients (74.2%): uptake in the thyroid bed was found in five patients, in the lymph nodes in 18 and in bone metastases in four. Using 99mTc-EDDA/HYNIC-TOC scintigraphy, the overall sensitivity was 79.5%, specificity 83.3%, accuracy 80.0%, positive predictive value 96.9% and negative predictive value 38.5%.

Conclusion

99mTc-EDDA/HYNIC-TOC is clinically useful for scintigraphy in the follow-up of patients with MTC. It can be used in clinical practice for preoperative evaluation, for localisation of local recurrence or distant metastases and particularly for therapy decision making.

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Authors and Affiliations

  1. Department of Endocrinology, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355, Poznań, Poland

    Rafał Czepczyński, Jerzy Kosowicz, Katarzyna Ziemnicka, Maria Gryczyńska & Jerzy Sowiński

  2. Nuclear Medicine, Ospedale S. Andrea, University Sapienza, Rome, Italy

    Maria Gemma Parisella & Alberto Signore

  3. Radioisotope Centre POLATOM, Otwock-Świerk, Poland

    Renata Mikołajczak

  4. Department of Nuclear Medicine & Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Alberto Signore

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  1. Rafał Czepczyński
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Correspondence to Rafał Czepczyński.

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Czepczyński, R., Parisella, M.G., Kosowicz, J. et al. Somatostatin receptor scintigraphy using 99mTc-EDDA/HYNIC-TOC in patients with medullary thyroid carcinoma. Eur J Nucl Med Mol Imaging 34, 1635–1645 (2007). https://doi.org/10.1007/s00259-007-0479-1

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  • DOI: https://doi.org/10.1007/s00259-007-0479-1

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