PT  - JOURNAL ARTICLE
AU  - ALMA SESTI
AU  - MARIUS MAYERHOEFER
AU  - MICHAEL WEBER
AU  - PHILIP ANNER
AU  - WOLFGANG WADSAK
AU  - ROBERT DUDCZAK
AU  - ALEXANDER HAUG
AU  - GEORGIOS KARANIKAS
TI  - Relevance of Calcitonin Cut-off in the Follow-up of Medullary Thyroid Carcinoma for Conventional Imaging and 18-Fluorine-Fluorodihydroxyphenylalanine PET
DP  - 2014 Nov 01
TA  - Anticancer Research
PG  - 6647--6654
VI  - 34
IP  - 11
4099  - http://ar.iiarjournals.org/content/34/11/6647.short
4100  - http://ar.iiarjournals.org/content/34/11/6647.full
SO  - Anticancer Res2014 Nov 01; 34
AB  - Aim: The American thyroid association (ATA) recommends that additional imaging procedures supplement cervical ultrasonography (US) in any patient with a basal calcitonin value above 150 pg/ml in the follow-up of medullary thyroid carcinoma (MTC). The aim of the present study was to reaffirm or challenge this cut-off for 18-Fluorine-Fluorodihydroxyphenylalanine positron emission tomography (18F-DOPA PET) and conventional imaging ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI)). Materials and Methods: Thirty-nine patients (18 females, 21 males), mean age 62 years, range from 35 to 86, followed-up for MTC were included in the present retrospective study. In our patients 64 18F-DOPA scans, 28 neck US, 28 CT and 8 MRI were performed. For all cases basal calcitonin values were available. Sensitivity and specificity of 18F-DOPA PET and conventional imaging (US, CT, MRI) related to calcitonin values were calculated. Results: According to the calcitonin cut-off of 150 pg/ml, we found the following sensitivities and specificities: 79% and 80% for 18F-DOPA PET, 75% and 92% for US, 80% and 25% for CT, 50% and 75% for MRI. Taking the level of detectable calcitonin, we calculated the following sensitivities: 52% for 18F-DOPA PET, 46% for US, 79% for CT and 38% for MRI. Conclusion: We cannot confirm the calcitonin cut-off proposed by the ATA for the detection of MTC recurrences and contemporaneously we cannot state that 18F-DOPA PET has a very high sensitivity. For the neck region 18F-DOPA PET and US showed similar results. 18F-DOPA PET/CT seems to be the best imaging modality for whole-body tumor detection. Bone metastases are best detected by MRI.