Update on management of medullary thyroid carcinoma

Treglia, Giorgio; Ruffini, Vittoria; Piccardo, Arnoldo; Imperiale, Alessio

doi:10.1053/j.semnuclmed.2023.01.003

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Journal article

Update on management of medullary thyroid carcinoma : focus on nuclear medicine

Treglia, Giorgio ORCID Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland - Faculty of Biomedical Sciences, Università della Svizzera italiana, Switzerland - Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne, Switzerland
Ruffini, Vittoria Section of Nuclear Medicine, Department of Radiological Sciences and Hematology, Università Cattolica del Sacro Cuore, Rome, Italy - Unit of Nuclear Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy - ENETS Center of Excellence for the Diagnosis and Cure of Neuroendocrine Tumors, Rome, Italy
Piccardo, Arnoldo ORCID Nuclear Medicine Department, Ente Ospedaliero “Ospedali Galliera”, Genoa, Italy
Imperiale, Alessio Nuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France - Faculty of Medicine, University of Strasbourg, Strasbourg, France - Molecular Imaging-DRHIM IPHC, UMR7178, CNRS/Unistra, Strasbourg, France

2023

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Seminars in nuclear medicine. - 2023, vol. 53, no. 4, p. 481-489

English Currently, there is a discrepancy among the available guidelines on the usefulness of nuclear medicine techniques in medullary thyroid cancer (MTC) diagnosis and treatment. Aim of this review is to provide an update on diagnostic and therapeutic nuclear medicine techniques in this setting. Evidence-based data clearly demonstrates the usefulness of PET/CT with different radiopharmaceuticals in recurrent MTC (in particular when serum calcitonin is higher than 150 pg/mL or calcitonin doubling time is shortened) and 18F-FDOPA should be the preferred PET radiopharmaceutical. If 18F-FDOPA PET/CT is negative or unavailable, 18F-FDG PET/CT or 68Ga-DOTA-peptides PET/CT could be performed for MTC restaging. There is currently insufficient evidence to recommend PET/CT with several radiopharmaceuticals for MTC staging. Clinical experience on PET/MRI with different radiopharmaceuticals in MTC is still limited. Several investigational nuclear medicine therapeutic options are currently under evaluation in metastatic MTC. More data are needed to evaluate the efficacy, toxicity, and role of these therapeutic options in the management of MTC patients.

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