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Synthesis and Functions of Calcitonin00:51

Synthesis and Functions of Calcitonin

Calcitonin, a vital polypeptide hormone, regulates calcium levels within body fluids. It is released by the parafollicular cells, also known as C cells, situated in the follicular epithelium of the thyroid gland. Calcitonin responds to fluctuations in blood calcium levels and the influence of gastrointestinal hormones like gastrin and cholecystokinin.
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Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...
Hyperthyroidism II: Pathophysiology01:27

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Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...
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Spontaneous Murine Model of Anaplastic Thyroid Cancer
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Published on: February 3, 2023

Imaging medullary thyroid carcinoma with persistent elevated calcitonin levels.

Anne Laure Giraudet1, Daniel Vanel, Sophie Leboulleux

  • 1Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy, 94805 Villejuif Cédex, France.

The Journal of Clinical Endocrinology and Metabolism
|August 30, 2007
PubMed
Summary

For medullary thyroid carcinoma (MTC) patients with elevated calcitonin, a combination of neck ultrasound, chest CT, liver MRI, and bone scintigraphy is most effective for detecting tumor sites. FDG PET scans showed lower sensitivity and limited prognostic value.

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Area of Science:

  • Oncology
  • Radiology
  • Nuclear Medicine

Background:

  • Elevated calcitonin levels after treatment in medullary thyroid carcinoma (MTC) patients often lack clear disease evidence on standard imaging.
  • This diagnostic gap necessitates the optimization of imaging procedures for accurate tumor site detection in MTC.

Purpose of the Study:

  • To evaluate and define optimal imaging procedures for detecting tumor sites in medullary thyroid carcinoma (MTC) patients with persistently elevated calcitonin levels.

Main Methods:

  • Fifty-five MTC patients with elevated calcitonin underwent a comprehensive imaging work-up including ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), bone scintigraphy, and FDG-PET/CT.
  • Specific imaging modalities were compared for their efficacy in detecting recurrence in the neck, lymph nodes, liver, and bone.

Main Results:

  • Neck US and CT demonstrated recurrence in 56% and 42% of patients, respectively. CT detected lung and mediastinal lymph node metastases in 35% and 31%, while PET showed 15% and 20%.
  • For liver metastases, MRI was most sensitive (49%), followed by CT (44%), US (41%), and PET (27%). Bone scintigraphy and MRI detected bone metastases in 40% of patients, with bone scintigraphy superior for peripheral lesions.
  • Ten patients (18%) had no detectable tumor site despite elevated calcitonin; FDG uptake showed overlap between progressive and stable disease.

Conclusions:

  • An optimal imaging strategy for MTC recurrence includes neck US, chest CT, liver MRI, bone scintigraphy, and axial skeleton MRI.
  • FDG PET/CT demonstrated lower sensitivity for detecting MTC tumor sites and had limited prognostic value in this patient cohort.