Theranostics of Thyroid Cancer

Area of Science:

• Oncology
• Nuclear Medicine
• Radiology

Background:

• Molecular imaging is crucial for evaluating and managing diverse thyroid cancer histotypes.
• Current risk stratification systems for thyroid cancer can be improved by integrating molecular and molecular imaging biomarkers.
• Theranostic approaches enable patient-specific treatment decisions in thyroid cancer management.

Purpose of the Study:

• To review the role and future perspectives of molecular imaging and theranostics in thyroid cancer.
• To highlight how molecular imaging refines risk stratification and treatment strategies for different thyroid cancer subtypes.
• To discuss advancements in theranostic applications for advanced and metastatic thyroid cancers.

Main Methods:

• Review of molecular imaging techniques including radioactive iodine isotopes (I-131, I-123, I-124) and PET/CT scans ([18F]FDG, 6-[18F]FDOPA).
• Analysis of theranostic strategies such as redifferentiation therapies and peptide receptor theranostics.
• Evaluation of molecular imaging in risk stratification and assessment of disease aggressiveness and metastases.

Main Results:

• Radioactive iodine isotopes are central to differentiated thyroid carcinoma (DTC) risk stratification.
• [18F]FDG PET/CT assesses aggressiveness and metastases in DTC, poorly differentiated, and anaplastic thyroid cancers.
• 6-[18F]FDOPA PET/CT is highly specific for medullary thyroid cancer (MTC); [18F]FDG PET/CT aids in aggressive MTC phenotypes.

Conclusions:

• Molecular imaging, combined with theranostics, offers personalized treatment for thyroid cancer patients.
• New redifferentiation strategies and peptide receptor theranostics show promise for radioiodine-refractory DTC and MTC.
• Integrating molecular imaging biomarkers refines thyroid cancer management, improving patient outcomes.