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Medullary Thyroid Carcinoma

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Therapeutic Nuclear Medicine

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

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Abstract

Overall survival after initial surgery in patients diagnosed with MTC is quite variable, but the rate decreases substantially after discovery of distant metastases depending on prognostic indicator values. In this context, nuclear medicine can play an important role both with diagnostic PET imaging, and radionuclide therapy. Among available imaging techniques, CT is the best for liver and lung and MRI for bone/bone marrow. MRI should be performed in MTC patients with increased serum calcitonin levels, even when bone scintigraphy is normal. FDG-PET/CT should be recommended for exploration of neck, mediastinum, and lungs, and CT and MRI for exploration of, respectively, liver and bone/bone marrow. There is a need for prognostic indicators allowing to have a clear distinction between high-risk patients who should be treated and low-risk patients who justify a “watchful waiting” management. The prognostic value of calcitonin (Ct) doubling time (DT) have been shown to be quite favorable. For this purpose, it can be recommended that sequential measurements (every month) of Ct serum levels be performed after primary surgery in the event of persisting abnormal titers allowing to calculate CtDT after a few months. Among current treatment modalities, chemotherapy is not accepted as a useful treatment of patients with metastatic disease. Effectiveness of radioimmunotherapy has been clearly documented as well as that of vandetanib, a multikinase inhibitor which has been approved for treatment of metastatic MTC.

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Authors and Affiliations

  1. GIP Arronax, University of Nantes, Nantes-Saint-Herblain, France

    Jean-François Chatal

  2. Cancer Research Center, CRCNA, Institut de Biologie, INSERM UMR892, Nantes, France

    Françoise Kraeber-Bodéré & Jacques Barbet

  3. Nuclear Medicine Department, University Hospital, René Gauducheau Cancer Center, IRCNA, Nantes-Saint-Herblain, France

    Françoise Kraeber-Bodéré

  4. Garden State Cancer Center, Center for Molecular Medicine and Immunology, Belleville, NJ, USA

    David M. Goldenberg

Authors
  1. Jean-François Chatal
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  2. Françoise Kraeber-Bodéré
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  3. David M. Goldenberg
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  4. Jacques Barbet
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Corresponding author

Correspondence to Jean-François Chatal .

Editor information

Editors and Affiliations

  1. THERANOSTICS Center for Molecular, Radiotherapy and Molecular Imaging, ENETS Center of Excellence, Bad Berka, Germany

    Richard P. Baum

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© 2012 Springer-Verlag Berlin Heidelberg

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Chatal, JF., Kraeber-Bodéré, F., Goldenberg, D.M., Barbet, J. (2012). Medullary Thyroid Carcinoma. In: Baum, R. (eds) Therapeutic Nuclear Medicine. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2012_695

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  • DOI: https://doi.org/10.1007/174_2012_695

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-36718-5

  • Online ISBN: 978-3-540-36719-2

  • eBook Packages: MedicineMedicine (R0)

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