| Imaging medullary thyroid carcinoma with persistent elevated calcitonin levels. | |
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MedLine Citation:
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PMID: 17726071 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2007-08-28 |
Journal Detail:
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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:
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Created Date: 2007-11-08 Completed Date: 2008-01-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375362 Medline TA: J Clin Endocrinol Metab Country: United States |
Other Details:
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Languages: eng Pagination: 4185-90 Citation Subset: AIM; IM |
Affiliation:
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Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy, 94805 Villejuif Cédex, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18; 9007-12-9/Calcitonin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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