gallium-ga-68-dotatate and Goiter--Nodular

The aim of this study was to evaluate a new imaging method 68Ga-DOTATATE PET/CT as an alternative method to diagnose evidence of neuroendocrine tumors or their metastasis (if any) in patient with MEN 2A.. Three patients( 2F, 1M; age 28,46 and 50 years) with MEN 2A syndrome who underwent 68Ga-DOTATATE PET/CT scan were prospectively evaluated. PET/CT images were analyzed with measurement of maximum standardized uptake value (SUVmax).. All patients had adrenal masses with increased uptake of 68Ga-DOTATATE (first case adrenal mass SUVmax: 9,1, second case adrenal mass SUVmax: 32,4(right), 30,3(left) and third case SUVmax:12,4). All of the patients had medullary thyroid carcinoma with increased uptake of 68Ga-DOTATATE (first case SUVmax: 3,3 second case SUVmax:7,7 and third case SUVmax: left thyroid nodule: 19,4, right thyroid nodule: 21,2). Third case has a parathyroid adenoma with SUVmax: 2,8.. New imaging method 68Ga-DOTATATE PET/CT may be an alternative method to diagnose MEN 2A patients. 68Ga-DOTATATE PET/CT can give a great opportunity to detecting the multiple neoplasia like MEN 2A with only one session.. MEN 2A syndrome, 68Ga-DOTATATE PET/CT, Neuroendocrine tumors.. Lo scopo di questo studio è di valutare un nuovo metodo di imaging 68Ga-DOTATATE PET/CT come metodo alternativo per diagnosticare l’evidenza di tumori neuroendocrini o le loro metastasi (se presenti) nel paziente con MEN 2A. Sono stati studiati prospetticamente tre pazienti (2 donne ed un uomo) di età rispettivamente di 28, 46 e 50 anni, con sindrome MEN 2A sottoposti a scansione PET / TC 68Ga-DOTATATE. Le immagini PET/CT sono state analizzate con la misurazione del massimo valore di assorbimento standardizzato (SUVmax). Tutti i pazienti presentavano masse surrenali con aumento dell’assorbimento di 68Ga-DOTATATE (massa surrenale del primo caso SUVmax: 9,1, massa surrenale del secondo caso SUVmax: 32,4 (destra) e 30,3 (sinistra) e terzo caso SUVmax: 12, 4). Tutti i pazienti avevano un carcinoma midollare della tiroide con aumento dell’assorbimento di 68Ga-DOTATATE (primo caso SUVmax: 3,3; secondo caso SUVmax: 7,7 e terzo caso SUVmax: nodulo tiroideo sinistro: 19,4, nodulo tiroideo destro: 21,2. Il terzo caso aveva un adenoma paratiroideo con SUVmax: 2,8. Si convlude che il nuovo metodo di imaging 68Ga- DOTATATE PET/CT può essere un metodo alternativo per diagnosticare i pazienti MEN 2A. La 68Ga- DOTATATE PET/CT può dare una grande opportunità per rilevare le neoplasie multiple come MEN 2A con una sola sessione di indagine.

Topics: Adrenal Gland Neoplasms; Adrenalectomy; Adult; Catecholamines; Female; Gallium Radioisotopes; Goiter, Nodular; Humans; Male; Metanephrine; Middle Aged; Multiple Endocrine Neoplasia Type 2a; Organometallic Compounds; Pheochromocytoma; Positron Emission Tomography Computed Tomography; Prospective Studies; Radiopharmaceuticals; Thyroid Neoplasms; Tissue Distribution

Differentiated thyroid carcinoma (DTC) has good prognosis but 5% of the patients already have distant metastasis at the diagnosis. Tumour cells can lose their iodine uptake ability and enter a state of dedifferentiation. Treatment for differentiated thyroid carcinoma that is not suitable for the local surgery and unresponsive to radioactive iodine uptake is not always easy for physicians. We present a case of a 64-year-old man who had total thyroidectomy surgery and central lymph node dissection with diagnosis of multinodular goitre disease. Histopathological evaluation was papillary thyroid cancer with tall cell variant. Treatment using 150 mCi radioiodine was administered to the patient three times but could not effect a cure. We performed Ga-68 labelled DOTATE (synthetic somatostatin analogue peptide). This provided a good outcome. As evident from our case, Lu-177 radionuclide labelled synthetic somatostatin analogue peptides have therapeutic effect on radioiodine refractory DTC, as an alternative treatment modality.

Topics: Aged; Carcinoma; Carcinoma, Papillary; Goiter, Nodular; Humans; Iodine Radioisotopes; Male; Neoplasm Metastasis; Octreotide; Organometallic Compounds; Peptides; Positron Emission Tomography Computed Tomography; Somatostatin; Thyroid Cancer, Papillary; Thyroid Neoplasms; Thyroidectomy

Thyroid diseases, which may occur as focal or diffuse changes in thyroid parenchyma, are most often observed in women.. Our aim was to assess the prevalence of incidental thyroid uptake of 68Ga-DOTATATE PET/CT in patients referred to the Nuclear Medicine Department for evaluation of neuroendocrine neoplasia (NEN).. We retrospectively evaluated 1150 68Ga-DOTATATE PET/CT images. Clinical history, serum TSH and thyroid antibody (TAb) concentrations, ultrasonography, and cytological assessment of the material from fine-needle aspiration biopsy (FNA) of the thyroid lesion were investigated.. We found incidental abnormalities in 46/1150 (4.1%) patients (12 men, 34 women). 34/46 patients (8 men, 26 women) showed diffuse 68Ga-DOTATATE thyroid uptake, with mean SUVmax 4.6 ± 1.6. Based on laboratory tests and ultrasound, we found: 38% of patients with an active autoimmune thyroiditis, 27% with benign goitre, and 6% with multinodular goitre with autoimmune thyroiditis. The remaining 29% of patients did not show any pathology. In 12/47 patients (4 men, 8 women) focal uptake in the thyroid with SUVmax 7.3 ± 3.3 was found. During one-year follow-up, category II and category III lesions (according to Bethesda classification) were revealed in 9/12 (75%) patients and in one patient, respectively. Histopathological examination after surgery revealed papillary thyroid carcinoma in one patient and benign multinodular goitre in another patient.. Patients with focal 68Ga-DOTATATE uptake should undergo further examination (FNA) due to potential risk of malignancy. Diffuse 68Ga-DOTATATE uptake was predominantly associated with active autoimmune thyroiditis or benign goitre. The focal lesions and diffuse pathology diseases were frequently seen in women.

Topics: Adult; Aged; Autoantibodies; Carcinoma; Carcinoma, Papillary; Female; Goiter, Nodular; Humans; Male; Middle Aged; Organometallic Compounds; Positron Emission Tomography Computed Tomography; Retrospective Studies; Thyroid Cancer, Papillary; Thyroid Gland; Thyroid Hormones; Thyroid Neoplasms; Thyroiditis, Autoimmune