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FDG PET imaging in hereditary thyroid cancer
1Department of Head and Neck Surgery, National Institute of Oncology, Budapest, Hungary.
Summary
Cervical ultrasound and whole-body FDG PET imaging are valuable tools for staging patients with multiple endocrine neoplasia 2A (MEN2A) or familial medullary thyroid carcinoma (FMTC). These methods aid in identifying primary tumors and lymph node metastases in gene carriers.
Area of Science:
- Endocrinology
- Oncology
- Radiology
Background:
- Multiple Endocrine Neoplasia 2A (MEN2A) and Familial Medullary Thyroid Carcinoma (FMTC) are genetic disorders associated with medullary thyroid carcinoma (MTC).
- Accurate staging is crucial for effective management of these conditions.
Purpose of the Study:
- To evaluate the efficacy of various imaging modalities in staging patients diagnosed with MEN2A or FMTC.
- To determine the role of cervical ultrasound, CT, MRI, MIBG scintigraphy, and FDG PET in identifying MTC and lymph node involvement.
Main Methods:
- Fourteen newly diagnosed gene carriers underwent a comprehensive imaging workup.
- Imaging techniques included cervical ultrasound (US), cervical and mediastinal CT, MRI, whole-body meta-[131I]iodobenzylguanidine (MIBG) scintigraphy, and [18F]fluorodeoxyglucose (FDG) PET scanning.
Main Results:
- Cervical US successfully identified seven primary MTCs.
- CT and MRI were limited to detecting tumors ≥5 mm.
- MIBG scintigraphy and FDG PET did not detect MTC within the thyroid.
- Whole-body FDG PET identified two true-positive and one false-positive lymph node metastasis, while MIBG scintigraphy did not detect lymph node metastases.
Conclusions:
- Cervical ultrasound and whole-body FDG PET are effective imaging methods for staging individuals with MEN2A or FMTC.
- These modalities assist in the precise staging of patients carrying the relevant mutant genes.