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Medullary Thyroid Carcinoma: An Update on Imaging.

Sergiy V Kushchayev1,2, Yevgeniya S Kushchayeva3, Sri Harsha Tella4

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Medullary thyroid carcinoma (MTC) is an aggressive cancer. Advanced imaging techniques like MRI and PET/CT offer new approaches for detecting primary and metastatic MTC.

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Area of Science:

  • Oncology
  • Radiology
  • Nuclear Medicine

Background:

  • Medullary thyroid carcinoma (MTC) originates from thyroid C cells, representing 1-2% of thyroid cancers.
  • MTC is often aggressive, with frequent metastasis to lymph nodes, lungs, liver, and bones.
  • Clinical application of advanced imaging in MTC management remains limited despite technological advancements.

Purpose of the Study:

  • To review the biology and molecular aspects of MTC.
  • To discuss current and modern imaging modalities for MTC detection and management.
  • To highlight the utility of advanced imaging in primary and metastatic MTC, including lymph node and distant metastases.

Main Methods:

  • Review of current literature on MTC biology and molecular characteristics.
  • Discussion of advanced magnetic resonance imaging (MRI) techniques: whole-body MRI, dynamic contrast-enhanced (DCE) MRI, and diffusion-weighted imaging (DWI).
  • Evaluation of positron emission tomography/computed tomography (PET/CT) with 18F-FDOPA and 18F-FDG, and integrated PET/MR hybrid imaging.

Main Results:

  • The article provides a background on MTC biology and molecular features relevant to imaging.
  • Detailed review of advanced MRI techniques (whole-body, DCE, DWI) for MTC assessment.
  • Comprehensive overview of PET/CT and PET/MR imaging applications in MTC, covering primary tumors and metastases.

Conclusions:

  • Understanding MTC biology is crucial for effective imaging interpretation.
  • Advanced imaging techniques, including MRI and PET-based methods, show promise for improved MTC management.
  • Integrated PET/MR imaging represents a novel approach for comprehensive MTC evaluation.