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Functional Oncological Imaging of the Endocrine System

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Abstract

Endocrine tumors are hormonally active benign or malignant neoplasms arising within endocrine organs or from specialized cells of the amine precursor uptake and decarboxylation (APUD) system that are increasing in incidence as a result of sensitive biochemical tests and high-resolution diagnostic imaging. Not unlike tumors of other systems, endocrine neoplasms are heterogenous with variable prognosis characterized by well-differentiated thyroid cancer with very favorable outcome, medullary thyroid cancer and neuroendocrine-type tumors with intermediate outcomes, and anaplastic thyroid, adrenocortical, and Merkel cell cancers with the poorest clinical outcomes. Medical imaging has become a key component in diagnosis and staging of endocrine malignancies; however, even with great advances in computed tomography and magnetic resonance imaging, detection of small primary tumors and metastases continues to be a challenge. Complimentary functional imaging targets tumor cellular processes that actively accumulate radiopharmaceuticals, allowing sensitive and highly specific oncological imaging. Surveillance of endocrine malignancies commonly combines functional imaging with tumor-specific laboratory biomarkers. Furthermore, functional imaging studies can predict efficacy of radionuclide or receptor-based therapies. The last decade has seen an increasing use of combined PET-CT and SPECT-CT scanners designed to create functional and anatomic maps with resultant incremental diagnostic capabilities. These technologies together with the development of novel PET and SPECT radiopharmaceuticals make patient-individualized functional imaging protocols possible, based on the histological grade, degree of differentiation, and genetic profile of their endocrine neoplasm.

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Abbreviations

AADC:

Aromatic amino acid decarboxylase

ACC:

Adrenocortical carcinoma

ACTH:

Adrenocorticotrophic hormone

APUD:

Amine precursor uptake and decarboxylation

ATC:

Anaplastic thyroid cancer

C11-HED:

C11-hydroxyephedrine

C11-HTP:

C11-5-hydroxy-L-tryptophan

C11-MTO:

C11-metomidate

CEA:

Carcino-embryonic antigen

CT:

Computed tomography

Ctn:

Calcitonin

DMSA:

Dimercaptosuccinic acid

DOTA:

1,4,7,10–tetraazacyclododecane–1,4,7,10–tetraacetic acid

DOTATATE:

DOTA-Ty3-octreotide

DOTANOC:

DOTA-NaI-octreotide

F18-FDA:

F18-fluorodopamine

FDG:

F18-fluoro-2-deoxy-D-glucose

F-DOPA:

6-L-F18-fluorodihydroxyphenylalanine

FTC:

Follicular thyroid cancer

GH:

Growth hormone

I-131:

Iodine-131

keV:

Kilo electron volt

LAT1:

Large neutral amino acid transporter

MCC:

Merkel cell carcinoma

MEN:

Multiple endocrine neoplasia

MIBG:

Metaiodobenzylguanidine

MIP:

Maximum intensity projection

MRI:

Magnetic resonance imaging

MTC:

Medullary thyroid cancer

NB:

Neuroblastoma

NETs:

Neuroendocrine tumors

OR:

Odds ratio

PET-CT:

Positron emission tomography-computed tomography

PGL:

Paraganglioma

PHEO:

Pheochromocytoma

PRL:

Prolactin

PTC:

Papillary thyroid cancer

SDHB:

Succinate dehydrogenase-subunit B

SPECT-CT:

Single-photon emission computed tomography-computed tomography

SRS:

Somatostatin receptor scintigraphy

SSTR:

Somatostatin receptors

SUV:

Standardized uptake value

Tc99m:

Metastable-technetium-99

TSH:

Thyroid stimulating hormone

VMAT:

Vesicular monoamine transporter

WDTC:

Well-differentiated thyroid cancer

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Authors and Affiliations

  1. Nuclear Medicine, Department of Radiology, University of Michigan Hospital, Ann Arbor, MI, 48109, USA

    Ka Kit Wong MBBS, Asha Kandathil MD & Milton D. Gross MD

  2. Nuclear Medicine Service, Department of Veterans Affairs Health System, Ann Arbor, MI, 48105, USA

    Ka Kit Wong MBBS & Milton D. Gross MD

  3. Nuclear Medicine, Department of Radiology, University of Michigan Medical Center, 1500 E Medical Center Dr., B1G505G, Ann Arbor, MI, 48105, USA

    Ka Kit Wong MBBS

  4. Nuclear Medicine, Department of Radiology, Medical Physics, Santa Maria della Misericordia Hospital, 45100, Rovigo, Italy

    Domenico Rubello MD

Authors
  1. Ka Kit Wong MBBS
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  2. Asha Kandathil MD
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  3. Domenico Rubello MD
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  4. Milton D. Gross MD
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Corresponding author

Correspondence to Ka Kit Wong MBBS .

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  1. Health Time Group, Jaén, Spain

    Antonio Luna

  2. Clinica Girona Hospital Sta. Caterina, Gerona, Spain

    Joan C. Vilanova

  3. CDPI and IRM, Botafongo - Rio de Janeiro/RJ, Brazil

    L. Celso Hygino Da Cruz Jr.

  4. Centro de Diagnóstico Dr. Enrique Rossi, Buenos Aires, Argentina

    Santiago E. Rossi

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Wong, K.K., Kandathil, A., Rubello, D., Gross, M.D. (2014). Functional Oncological Imaging of the Endocrine System. In: Luna, A., Vilanova, J., Hygino Da Cruz Jr., L., Rossi, S. (eds) Functional Imaging in Oncology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-40582-2_28

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  • DOI: https://doi.org/10.1007/978-3-642-40582-2_28

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