Role of nuclear medicine in the diagnosis and therapy of medullary thyroid carcinoma.

V. Rufini, M. Salvatori, M. C. Garganese, D. Di Giuda, M. Lodovica Maussier, L. Troncone

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Abstract

Medullary thyroid carcinoma (MTC) originates in the parafollicular cells (C cells) of the thyroid, secreting both calcitonin and CEA. Genetic and biochemical testing allow early pre-clinical identification of familial forms. Sporadic MTC usually presents as a solitary palpable thyroid nodule and in most cases the definitive diagnosis is established only at the time of surgery. Nuclear medicine procedures, which play a minor role in the preoperative evaluation of MTC, are essential in postoperative follow-up to detect residual and/or recurrent tumor. A number of radiopharmaceuticals are able to visualize MTC lesions with considerable advantages in diagnosis and prognosis, some of them having also a therapeutic role. Among them, 99mTc[V]DMSA shows the highest diagnostic sensitivity and is considered by many authors the radiopharmaceutical of choice in the postoperative work-up of MTC. Radioiodinated MIBG, in spite of its high specificity has a poor sensitivity (30%); however it is useful for the identification of pheochromocytoma and, in patients showing MIBG uptake in tumoral lesions, high activities of 131I-MIBG may be used for therapy. 111In labeled octreotide detects lesions which express somatostatin receptors; a positive scintigraphic result seems to give also prognostic information (higher uptake in slow-growing lesions) and provides the basis for treatment with octreotide or lanreotide and 111In or 90Y-labeled octreotide analogues. Interesting perspectives are offered by 18F-FDG PET and monoclonal anti-CEA labeled antibodies; the latter may be also used for therapy.

Original languageEnglish
Pages (from-to)273-282
Number of pages10
JournalRays - International Journal of Radiological Sciences
Volume25
Issue number2
Publication statusPublished - 2000

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Nuclear Medicine
3-Iodobenzylguanidine
Octreotide
Radiopharmaceuticals
Technetium Tc 99m Dimercaptosuccinic Acid
Therapeutics
Somatostatin Receptors
Thyroid Nodule
Fluorodeoxyglucose F18
Calcitonin
Genetic Testing
Pheochromocytoma
Thyroid Gland
Medullary Thyroid cancer
Antibodies
Neoplasms

Cite this

Rufini, V., Salvatori, M., Garganese, M. C., Di Giuda, D., Lodovica Maussier, M., & Troncone, L. (2000). Role of nuclear medicine in the diagnosis and therapy of medullary thyroid carcinoma. Rays - International Journal of Radiological Sciences, 25(2), 273-282.

Role of nuclear medicine in the diagnosis and therapy of medullary thyroid carcinoma. / Rufini, V.; Salvatori, M.; Garganese, M. C.; Di Giuda, D.; Lodovica Maussier, M.; Troncone, L.

In: Rays - International Journal of Radiological Sciences, Vol. 25, No. 2, 2000, p. 273-282.

Research output: Contribution to journalArticle

Rufini, V, Salvatori, M, Garganese, MC, Di Giuda, D, Lodovica Maussier, M & Troncone, L 2000, 'Role of nuclear medicine in the diagnosis and therapy of medullary thyroid carcinoma.', Rays - International Journal of Radiological Sciences, vol. 25, no. 2, pp. 273-282.
Rufini, V. ; Salvatori, M. ; Garganese, M. C. ; Di Giuda, D. ; Lodovica Maussier, M. ; Troncone, L. / Role of nuclear medicine in the diagnosis and therapy of medullary thyroid carcinoma. In: Rays - International Journal of Radiological Sciences. 2000 ; Vol. 25, No. 2. pp. 273-282.
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