TY - JOUR
T1 - 111In-octreotide scintigraphy for identification of metastatic medullary thyroid carcinoma in children and adolescents
AU - Lodish, Maya
AU - Dagalakis, Urania
AU - Chen, Clara C.
AU - Sinaii, Ninet
AU - Whitcomb, Patricia
AU - Aikin, Alberta
AU - Dombi, Eva
AU - Marcus, Leigh
AU - Widemann, Brigitte
AU - Fox, Elizabeth
AU - Chuk, Meredith
AU - Balis, Frank
AU - Wells, Samuel
AU - Stratakis, Constantine A.
PY - 2012/2
Y1 - 2012/2
N2 - Context: Most medullary thyroid cancers (MTC) express somatostatin receptors; therefore, 111Inoctreotide somatostatin receptor scintigraphy (SRS) may be useful in detecting sites of metastases in children with MTC. Objective: The aim of the study was to evaluate tumor metastases in children and adolescents with MTC using SRS in comparison to conventional imaging. Design and Setting:Acase series was conducted as part of baseline evaluation for cancer treatment protocol at the National Institutes of Health Clinical Center. Patients: Eleven patients with a median age of 15 (range, 9-17) yr participated in the study, 10 with histologically proven, metastatic MTC due to the M918T mutation of the RET protooncogene, and one with a known RET polymorphism. Intervention: After receiving 0.086 mCi/kg 111Indium- pentreotide, patients were examined with a single photon emission computed tomography scan 4 and 24 h after injection. Baseline conventional imaging, including computed tomography (neck, chest, abdomen, ± pelvis, adrenals), magnetic resonance imaging (neck), and bone scan, was performed on all patients. Main Outcome Measures: SRS results were compared with conventional imaging. Results: Five of the 11 patients had abnormal findings on SRS. Of the 53 total target lesions present in the patients, only 24.5% were accurately identified through SRS. Conclusions: SRS appears to be less sensitive than conventional imaging at detecting the full extent of metastatic disease in children and adolescents with hereditary MTC. SRS incompletely identified sites of tumor and failed to visualize small sites of tumor or liver and lung metastases, and it has a limited role in the evaluation of metastatic disease in pediatric MTC patients.
AB - Context: Most medullary thyroid cancers (MTC) express somatostatin receptors; therefore, 111Inoctreotide somatostatin receptor scintigraphy (SRS) may be useful in detecting sites of metastases in children with MTC. Objective: The aim of the study was to evaluate tumor metastases in children and adolescents with MTC using SRS in comparison to conventional imaging. Design and Setting:Acase series was conducted as part of baseline evaluation for cancer treatment protocol at the National Institutes of Health Clinical Center. Patients: Eleven patients with a median age of 15 (range, 9-17) yr participated in the study, 10 with histologically proven, metastatic MTC due to the M918T mutation of the RET protooncogene, and one with a known RET polymorphism. Intervention: After receiving 0.086 mCi/kg 111Indium- pentreotide, patients were examined with a single photon emission computed tomography scan 4 and 24 h after injection. Baseline conventional imaging, including computed tomography (neck, chest, abdomen, ± pelvis, adrenals), magnetic resonance imaging (neck), and bone scan, was performed on all patients. Main Outcome Measures: SRS results were compared with conventional imaging. Results: Five of the 11 patients had abnormal findings on SRS. Of the 53 total target lesions present in the patients, only 24.5% were accurately identified through SRS. Conclusions: SRS appears to be less sensitive than conventional imaging at detecting the full extent of metastatic disease in children and adolescents with hereditary MTC. SRS incompletely identified sites of tumor and failed to visualize small sites of tumor or liver and lung metastases, and it has a limited role in the evaluation of metastatic disease in pediatric MTC patients.
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U2 - 10.1210/jc.2011-2766
DO - 10.1210/jc.2011-2766
M3 - Article
C2 - 22162469
AN - SCOPUS:84863034134
SN - 0021-972X
VL - 97
SP - E207-E212
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 2
ER -