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68Ga-DOTATATE-PET shows promise for diagnosis of recurrent or persistent medullary thyroid cancer: A systematic review

  • Carla Pajak
    Affiliations
    Auckland City Hospital, Department of General Surgery, Grafton, Auckland, New Zealand
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  • Lina Cadili
    Affiliations
    Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada

    Department of Surgery Providence Health Care, St. Paul's Hospital, Vancouver, British Columbia, Canada
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  • Kylie Nabata
    Affiliations
    Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada

    Department of Surgery Providence Health Care, St. Paul's Hospital, Vancouver, British Columbia, Canada
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  • Sam M. Wiseman
    Correspondence
    Corresponding author. Department of Surgery, St. Paul's Hospital, C303-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
    Affiliations
    Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada

    Department of Surgery Providence Health Care, St. Paul's Hospital, Vancouver, British Columbia, Canada
    Search for articles by this author

      Highlights

      • 68Ga-DOTATATE-PET has a role in imaging MTC patients with suspected recurrence.
      • 68Ga-DOTATATE-PET may be complementary to 18F-FDG-PET when imaging MTC patients for recurrence.
      • The cost and technicalities of 68Ga-DOTATATE-PET should be considered.

      Abstract

      Background

      Many patients with Medullary Thyroid Cancer (MTC) will have persistent or recurrent disease after surgery requiring lifelong surveillance with imaging and tumor markers. The objective of this study is to evaluate the efficacy of 68Ga-DOTATATE-PET (or 68Ga labelled equivalent radiopharmaceutical) versus 18F-FDG-PET for detecting persistent and/or metastatic recurrent MTC.

      Methods

      Relevant studies were identified by conducting searches in Embase and PubMed and five studies were included in the final review.

      Results

      Five studies investigated per-patient sensitivity of 18F-FDG-PET and 68Ga-DOTATATE-PET in MTC patients. Four studies investigated the correlation between calcitonin and number of lesions detected by 18F-FDG-PET and 68Ga-DOTATATE-PET, and three investigated the correlation between CEA and number of lesions detected by 18F-FDG-PET and 68Ga-DOTATATE-PET. There was no significant difference in number of lesions detected by 18F-FDG -PET compared with 68Ga-DOTATATE-PET.

      Conclusions

      When compared directly to 18F-FDG-PET, there is a general trend towards favoring 68Ga-DOTATATE-PET in per-patient sensitivities, and incidence of lesion detection.

      Keywords

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      References

        • Kushchayev S.V.
        • Kushchayeva Y.S.
        • Tella S.H.
        • Glushko T.
        • Pacak K.
        • Teytelboym O.M.
        Medullary thyroid carcinoma: an update on imaging.
        J Thyroid Res. 2019; 2019: 1-17https://doi.org/10.1155/2019/1893047
      1. Revised American thyroid association guidelines for the management of medullary thyroid carcinoma.
        Pediatrics. 2018; 142e20183062https://doi.org/10.1542/peds.2018-3062
        • Moley J.F.
        Medullary thyroid carcinoma: management of lymph node metastases.
        J Natl Compr Cancer Netw. 2010; 8: 549-556https://doi.org/10.6004/jnccn.2010.0042
        • Quayle F.J.
        • Moley J.F.
        Medullary thyroid carcinoma: management of lymph node metastases.
        Curr Treat Options Oncol. 2005; 6: 347-354https://doi.org/10.1007/s11864-005-0038-6
        • Treglia G.
        • Castaldi P.
        • Villani M.F.
        • et al.
        Comparison of 18F-DOPA, 18F-FDG and 68Ga-somatostatin analogue PET/CT in patients with recurrent medullary thyroid carcinoma.
        Eur J Nucl Med Mol Imag. 2012; 39: 569-580https://doi.org/10.1007/s00259-011-2031-6
        • Wells S.A.
        • Asa S.L.
        • Dralle H.
        • et al.
        Revised American thyroid association guidelines for the management of medullary thyroid carcinoma.
        Thyroid. 2015; 25: 567-610https://doi.org/10.1089/thy.2014.0335
        • Sterne J.A.C.
        • Egger M.
        • Smith G.D.
        Systematic reviews in health care: investigating and dealing with publication and other biases in meta-analysis.
        BMJ. 2001; 323: 101-105https://doi.org/10.1136/bmj.323.7304.101
        • Cumpston M.
        • Li T.
        • Page M.J.
        • et al.
        Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions.
        Cochrane Database Syst Rev. 2019; (October)https://doi.org/10.1002/14651858.ED000142
        • Conry B.G.
        • Papathanasiou N.D.
        • Prakash V.
        • et al.
        Comparison of 68Ga-DOTATATE and 18F-fluorodeoxyglucose PET/CT in the detection of recurrent medullary thyroid carcinoma.
        Eur J Nucl Med Mol Imag. 2010; 37: 49-57https://doi.org/10.1007/s00259-009-1204-z
        • Naswa N.
        • Sharma P.
        • Suman K.C.S.
        • et al.
        Prospective evaluation of 68Ga-DOTA-NOC PET-CT in patients with recurrent medullary thyroid carcinoma.
        Nucl Med Commun. 2012; 33: 766-774https://doi.org/10.1097/MNM.0b013e3283541157
        • Ozkan Z.G.
        • Kuyumcu S.
        • Uzum A.K.
        • et al.
        Comparison of 68Ga-DOTATATE PET-CT, 18F-FDG PET-CT and 99mTc-(V)DMSA scintigraphy in the detection of recurrent or metastatic medullary thyroid carcinoma.
        Nucl Med Commun. 2015; 36: 242-250https://doi.org/10.1097/MNM.0000000000000240
        • Şahin E.
        • Elboğa U.
        The role of tumour biomarkers in choosing the appropriate positron emission tomography imaging in follow‐up of medullary thyroid cancer.
        J Med Imaging Radiat Oncol. 2020; 64: 756-761https://doi.org/10.1111/1754-9485.13081
        • Rufini V.
        • Castaldi P.
        • Treglia G.
        • et al.
        Nuclear medicine procedures in the diagnosis and therapy of medullary thyroid carcinoma.
        Biomed Pharmacother. 2008; 62: 139-146https://doi.org/10.1016/j.biopha.2007.07.011
        • Papotti M.
        • Kumar U.
        • Volante M.
        • Pecchioni C.
        • Patel Y.C.
        Immunohistochemical detection of somatostatin receptor types 1-5 in medullary carcinoma of the thyroid.
        Clin Endocrinol. 2001; 54: 641-649https://doi.org/10.1046/j.1365-2265.2001.01175.x
        • Maffione A.M.
        • Giammarile F.
        • Rubello D.
        SPECT/CT and PET/CT molecular imaging in medullary thyroid carcinoma. Are we running in the right direction?.
        Eur J Nucl Med Mol Imag. 2017; 44: 1692-1694https://doi.org/10.1007/s00259-017-3757-6
        • Musholt T.J.
        • Musholt P.B.
        • Dehdashti F.
        • Moley J.F.
        Evaluation of fluorodeoxyglucose-positron emission tomographic scanning and its association with glucose transporter expression in medullary thyroid carcinoma and pheochromocytoma: a clinical and molecular study.
        Surgery. 1997; 122: 1049-1061https://doi.org/10.1016/S0039-6060(97)90208-7
        • Ong S.C.
        • Schoder H.
        • Patel S.G.
        • et al.
        Diagnostic accuracy of 18F-FDG PET in restaging patients with medullary thyroid carcinoma and elevated calcitonin levels.
        J Nucl Med. 2007; 48: 501-507https://doi.org/10.2967/jnumed.106.036681
        • Tran K.
        • Khan S.
        • Taghizadehasl M.
        • et al.
        Gallium-68 dotatate PET/CT is superior to other imaging modalities in the detection of medullary carcinoma of the thyroid in the presence of high serum calcitonin.
        Hellenic J Nucl Med. 2015; 18: 19-24https://doi.org/10.1967/s002449910163
        • Vriens D.
        • Adang E.M.M.
        • Netea-Maier R.T.
        • et al.
        Cost-effectiveness of FDG-PET/CT for cytologically indeterminate thyroid nodules: a decision analytic approach.
        J Clin Endocrinol Metab. 2014; 99: 3263-3274https://doi.org/10.1210/jc.2013-3483
        • Shell J.
        • Keutgen X.M.
        • Millo C.
        • et al.
        68-Gallium DOTATATE scanning in symptomatic patients with negative anatomic imaging but suspected neuroendocrine tumor.
        Int J Endocr Oncol. 2018; 5: IJE04https://doi.org/10.2217/ije-2017-0005
        • Thisgaard H.
        • Kumlin J.
        • Langkjær N.
        • et al.
        Multi-curie production of gallium-68 on a biomedical cyclotron and automated radiolabelling of PSMA-11 and DOTATATE.
        EJNMMI Radiopharm Chem. 2021; 6: 1https://doi.org/10.1186/s41181-020-00114-9