[Imaging of medullary thyroid carcinoma]

Area of Science:

• Oncology
• Radiology
• Endocrinology

Background:

• Medullary thyroid carcinoma (MTC) accounts for 10% of thyroid cancers, presenting sporadically, familially, or with type II multiple endocrine neoplasia (MEN).
• Imaging is essential for screening MTC family members and for diagnosis.

Purpose of the Study:

• To outline the diagnostic and staging modalities for medullary thyroid carcinoma.
• To emphasize the role of various imaging techniques in MTC management.
• To discuss current and emerging treatment strategies for MTC.

Main Methods:

• Diagnosis involves ultrasound (US), scintigraphy, serum calcitonin, CEA, and fine needle biopsy.
• High-resolution US and CT of the mediastinum are key for locoregional staging.
• PET-CT with 18-F-DOPA is valuable for detecting occult metastases when tumor markers rise.

Main Results:

• Cytologic findings of a hypoechoic nodule with elevated calcitonin and CEA confirm diagnosis.
• US is the primary imaging tool for follow-up; CT is used for suspected metastases.
• MRI is recommended over CT to minimize radiation exposure during follow-up.

Conclusions:

• MTC is surgically curable but often progresses slowly, with long survival even in metastatic cases.
• While surgery is curative, targeted therapies are emerging for advanced or aggressive MTC variants.
• Effective imaging and monitoring are crucial for managing MTC patients.