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The Clinical Utility of Gallium-68-DOTATATE Positron Emission Tomography Scanning in Medullary Thyroid Cancer.
Gild, Matti L; Kumar, Shejil; Fuchs, Talia L; Glover, Anthony; Sidhu, Stan; Sywak, Mark; Tsang, Venessa; Gill, Anthony J; Robinson, Bruce G; Schembri, Geoffrey; Clifton-Bligh, Roderick J; Hoang, Jeremy.
Affiliation
  • Gild ML; Department of Endocrinology and Diabetes, Royal North Shore Hospital, Sydney, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, Australia. Electronic address: matti.gild@sydney.edu.au.
  • Kumar S; Department of Endocrinology and Diabetes, Royal North Shore Hospital, Sydney, Australia.
  • Fuchs TL; NSW Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, Australia; Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital, Sydney, Australia.
  • Glover A; Department of Endocrine Surgery, Royal North Shore Hospital, Sydney, Australia.
  • Sidhu S; Department of Endocrine Surgery, Royal North Shore Hospital, Sydney, Australia.
  • Sywak M; Department of Endocrine Surgery, Royal North Shore Hospital, Sydney, Australia.
  • Tsang V; Department of Endocrinology and Diabetes, Royal North Shore Hospital, Sydney, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
  • Gill AJ; Faculty of Medicine and Health, University of Sydney, Sydney, Australia; NSW Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, Australia; Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital, Sydney, Australia
  • Robinson BG; Department of Endocrinology and Diabetes, Royal North Shore Hospital, Sydney, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
  • Schembri G; Department of Nuclear Medicine, Royal North Shore Hospital, Sydney, Australia.
  • Clifton-Bligh RJ; Department of Endocrinology and Diabetes, Royal North Shore Hospital, Sydney, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
  • Hoang J; Department of Nuclear Medicine, Royal North Shore Hospital, Sydney, Australia.
Endocr Pract ; 30(3): 218-224, 2024 Mar.
Article in En | MEDLINE | ID: mdl-38103829
ABSTRACT

OBJECTIVE:

Somatostatin receptor (SST) functional imaging with positron emission tomography (PET)/computed tomography (CT) has broadened the diagnostic and staging capabilities for medullary thyroid cancer (MTC). Gallium-68 (68Ga)-DOTA-conjugated peptide (Tyr3)-octreotate (DOTATATE) is a radiotracer with a high affinity for type 2 SSTs expressed in several, but not all, MTCs. The utility of 68Ga-DOTATATE PET/CT and 18fluorine-labeled fluoro-2-deoxy-D-glucose (18F-FDG)-PET/CT imaging in predicting MTC prognosis is also unknown.

METHODS:

In this single-center retrospective study, 103 of patients with MTC underwent assessment of SST2 and SST5 immunohistochemistry (IHC). A subgroup of 37 patients received 68Ga-DOTATATE PET/CT imaging, and 13 received contemporaneous 18F-FDG-PET/CT imaging. The maximum standardized uptake value (SUV), mean SUV, metabolic tumor volume, and total lesion activity (TLA) were assessed.

RESULTS:

Forty-two patients (41%) demonstrated positive expression of SST2, and 45 (44%) had a positive SST5 IHC result. Seventeen patients (17%) expressed both SST2 and SST5. No survival advantage was identified with SST2 or SST5 IHC positivity. No correlation was noted between the maximum SUV, mean SUV, metabolic tumor volume, or TLA and SST2 and/or SST5 expression by IHC. Shorter survival was associated with a TLA of >20 (P = .04). A RET-negative status also appeared to have shorter survival, although this may be because the small numbers did not reach statistical significance (P = .12).

CONCLUSION:

Assessment of TLA from 68Ga-DOTATATE PET/CT may predict survival. SST2 IHC was not correlated with 68Ga-DOTATATE avidity. Metastatic disease may be optimally assessed by concurrent 18F-FDG and 68Ga-DOTATATE imaging.
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Full text: 1 Database: MEDLINE Main subject: Organometallic Compounds / Thyroid Neoplasms / Radionuclide Imaging / Neuroendocrine Tumors / Carcinoma, Neuroendocrine Limits: Humans Language: En Year: 2024 Type: Article
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Full text: 1 Database: MEDLINE Main subject: Organometallic Compounds / Thyroid Neoplasms / Radionuclide Imaging / Neuroendocrine Tumors / Carcinoma, Neuroendocrine Limits: Humans Language: En Year: 2024 Type: Article