The use of positron emission tomography/computed tomography (PET/CT) for the diagnosis and management of medullary thyroid carcinoma (MTC) does not appear to be generalized in Spain, according to a recently published study in the Revista Española de Medicina Nuclear e Imagen Molecular (Spanish Journal of Nuclear Medicine and Molecular Imaging).

Evidence shows that fluorodopa (F-DOPA) PET/CT can detect MTC lesions with excellent sensitivity, thus playing an important role in patients with a suspicion of refractory disease or evidence suggestive of disease relapse. F-fluorodeoxyglucose (FDG) PET/CT also has an important role in the management of patients with aggressive disease and calcitonin levels over 500 pg/mL.

Unfortunately, there are no studies regarding the use of PET/CT imaging studies in Spain for endocrine conditions such as MTC, differentiated thyroid cancer, hyperparathyroidism, and neuroendocrine tumors.


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Therefore, the authors aimed to assess the current use of PET/CT imaging in the field of endocrinology through a nationwide survey. The survey was distributed through various social networks during the first quarter of 2022. The focus was on the number of patients with MTC assessed by each hospital, as well as the role of PET/CT imaging in MTC diagnosis and biochemical recurrence.

“The objective was to obtain a snapshot of the use of PET/CT in nuclear endocrinology, to know if it is being used properly and detect possible needs,” the authors explained.

In the 13 hospitals that responded to the survey, 11 reported the use of F-DOPA PET/CT in patients with biological MTC recurrence. However, the mean number of studies performed per year among these centers was only 7.8, ranging from 2 to 20. The departments that requested this study in the included hospitals were otorhinolaryngology and endocrinology.

The authors explained that not all hospitals possess the necessary equipment to perform this type of study and that most cases of MTC are centralized in large hospitals with a high degree of expertise.

Although the researchers hypothesized that the lack of clear guidelines regarding PET/CT in nuclear endocrinology could also be a factor limiting its widespread use, the small sample size was recognized as an important limitation of the study.

“The use of the PET/CT technique in endocrinology is not yet generalized,” the authors wrote. “However, the data obtained from the survey performed show that the indications for which it is used are, in general, those described in the different consensus documents.”

Reference

Negre Busó M, Estorch Cabrera M, Mitjavila Casanovas M; en nombre del Grupo de Trabajo de Endocrinología de la SEMNIM. PET/CT in nuclear endocrinology: results of the survey diffused through different social networks of the SEMNIM in Spain. Rev Esp Med Nucl Imagen Mol (Engl Ed). Published online November 17, 2022. doi:10.1016/j.remnie.2022.11.003