A new study reports added value in utilizing 18F-DOPA positron emission tomography/computed tomography (PET/CT) imaging in patients with medullary thyroid cancer (MTC) together with conventional imaging procedures. The study, published in Endocrine, found that the combined approach led to changes in treatment strategies in 40% of patients.
“We aimed to assess the clinical usefulness of 18F-DOPA PET/CT in patients with MTC and elevated serum tumor markers, evaluating changes in disease management secondary to the findings observed with this methodology, in addition to the information provided by standard imaging procedures,” the authors explained.
The research team included 36 consecutive systemic treatment-naïve patients with MTC and calcitonin levels ≥150 pg/mL from August 2016 to November 2019. In addition to standard imaging procedures, including neck ultrasound, contrast-enhanced chest CT, and liver magnetic resonance imaging, all patients underwent whole-body 18F-DOPA PET/CT to assess disease extent. Abnormal findings were obtained in more than 90% of patients, showing a high disease detection sensitivity with this approach.
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The findings led to significant management changes in 40% of patients, including performing surgical procedures on locoregional lymph nodes and changing planned surgical interventions in those found not to have distant metastases.
International guidelines currently conflict regarding recommendations on when and with whom to use 18F-DOPA PET/CT. The authors of this study suggest that 18F-DOPA PET/CT might be most useful for patients with biochemical recurrence and limited disease extension or in cases of isolated cervical or mediastinal lymph nodes, for whom a highly accurate assessment of disease extent is critical for planning the surgical approach. A notable advantage of utilizing 18F-DOPA PET/CT is that it allows a whole-body assessment in one procedure, therefore simplifying the follow-up protocol for patients.
Inés C, Fabián P, Roxana C, Alejandra S, José BM. Prospective study on the clinical relevance of 18F-DOPA positron emission tomography/computed tomography in patients with medullary thyroid carcinoma. Endocrine. Published online April 30, 2022. doi:10.1007/s12020-022-03062-3