Document Detail


Imaging medullary thyroid carcinoma with persistent elevated calcitonin levels.
MedLine Citation:
PMID:  17726071     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Because calcitonin level remains elevated after initial treatment in many medullary thyroid carcinoma (MTC) patients without evidence of disease in the usual imaging work-up, there is a need to define optimal imaging procedures. PATIENTS AND METHODS: Fifty-five consecutive elevated calcitonin level MTC patients were enrolled to undergo neck and abdomen ultrasonography (US); neck, chest, and abdomen spiral computed tomography (CT); liver and whole-body magnetic resonance imaging (MRI); bone scintigraphy; and 2-[fluorine-18]fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET)/CT scan (PET). RESULTS: Fifty patients underwent neck US, CT, and PET, and neck recurrence was demonstrated in 56, 42, and 32%, respectively. Lung and mediastinum lymph node metastases in the 55 patients were demonstrated in 35 and 31% by CT and in 15 and 20% by PET. Liver imaging with MRI, CT, US, and PET in 41 patients showed liver in 49, 44, 41, and 27% patients, respectively. Bone metastases in 55 patients were demonstrated in 35% by PET, 40% by bone scintigraphy, and 40% by MRI; bone scintigraphy was complementary with MRI for axial lesions but superior for the detection of peripheral lesions. Ten patients had no imaged tumor site despite elevated calcitonin level (median 196 pg/ml; range 39-816). FDG uptake in neoplastic foci was higher in progressive patients but with a considerable overlap with stable ones. CONCLUSION: The most efficient imaging work-up for depicting MTC tumor sites would consist of a neck US, chest CT, liver MRI, bone scintigraphy, and axial skeleton MRI. FDG PET scan appeared to be less sensitive and of low prognostic value.
Authors:
Anne Laure Giraudet; Daniel Vanel; Sophie Leboulleux; Anne Aupérin; Clarisse Dromain; Linda Chami; Noël Ny Tovo; Jean Lumbroso; Nathalie Lassau; Guillaume Bonniaud; Dana Hartl; Jean-Paul Travagli; Eric Baudin; Martin Schlumberger
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-08-28
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  92     ISSN:  0021-972X     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-11-08     Completed Date:  2008-01-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  4185-90     Citation Subset:  AIM; IM    
Affiliation:
Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy, 94805 Villejuif Cédex, France.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Bone Neoplasms / diagnosis,  secondary
Bone and Bones / radionuclide imaging
Calcitonin / blood*
Carcinoma, Medullary / metabolism*,  pathology*
Female
Fluorodeoxyglucose F18 / diagnostic use
Head and Neck Neoplasms / diagnosis,  pathology
Humans
Image Processing, Computer-Assisted
Liver / pathology
Liver Neoplasms / diagnosis,  secondary
Lung Neoplasms / diagnosis,  secondary
Lymphatic Metastasis / diagnosis,  pathology
Magnetic Resonance Imaging
Male
Middle Aged
Neoplasm Recurrence, Local / diagnosis,  pathology
Positron-Emission Tomography
Prognosis
Radiopharmaceuticals / diagnostic use
Thyroid Neoplasms / metabolism*,  pathology*
Tomography, X-Ray Computed
Whole-Body Counting
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18; 9007-12-9/Calcitonin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Serum 25-hydroxyvitamin D measurement in a large population survey with statistical harmonization of...
Next Document:  Phenotypic effects of null and haploinsufficiency of acid-labile subunit in a family with two novel ...