Generic placeholder image

Current Molecular Medicine

Editor-in-Chief

ISSN (Print): 1566-5240
ISSN (Online): 1875-5666

Review Article

Nuclear Imaging Modalities in the Diagnosis and Management of Thyroid Cancer

Author(s): Namit Kant Singh*, Neemu Hage, Balaji Ramamourthy, Sushmitha Nagaraju and Krishna Medha Kappagantu

Volume 24, Issue 9, 2024

Published on: 22 September, 2023

Page: [1091 - 1096] Pages: 6

DOI: 10.2174/1566524023666230915103723

Price: $65

Abstract

In this review we have brought forward various nuclear imaging modalities used in the diagnosis, staging, and management of thyroid cancer. Thyroid cancer is the most common endocrine malignancy, accounting for approximately 3% of all new cancer diagnoses. Nuclear imaging plays an important role in the evaluation of thyroid cancer, and the use of radioiodine imaging, FDG imaging, and somatostatin receptor imaging are all valuable tools in the management of this disease. Radioiodine imaging involves the use of Iodine-123 [I-123] or Iodine-131 [I-131] to evaluate thyroid function and detect thyroid cancer. I-123 is a gamma-emitting isotope that is used in thyroid imaging to evaluate thyroid function and detect thyroid nodules. I-131 is a beta-emitting isotope that is used for the treatment of thyroid cancer. Radioiodine imaging is used to detect the presence of thyroid nodules and evaluate thyroid function. FDG imaging is a PET imaging modality that is used to evaluate the metabolic activity of thyroid cancer cells. FDG is a glucose analogue that is taken up by cells that are metabolically active, such as cancer cells. FDG PET/CT can detect primary thyroid cancer and metastatic disease, including lymph nodes and distant metastases. FDG PET/CT is also used to monitor treatment response and detect the recurrence of thyroid cancer. Somatostatin receptor imaging involves the use of radiolabeled somatostatin analogues to detect neuroendocrine tumors, including thyroid cancer. Radiolabeled somatostatin analogues, such as Indium-111 octreotide or Gallium-68 DOTATATE, are administered to the patient, and a gamma camera is used to detect areas of uptake. Somatostatin receptor imaging is highly sensitive and specific for the detection of metastatic thyroid cancer.

A comprehensive search of relevant literature was done using online databases of PubMed, Embase, and Cochrane Library using the keywords "thyroid cancer," "nuclear imaging," "radioiodine imaging," "FDG PET/CT," and "somatostatin receptor imaging" to identify relevant studies to be included in this review.

Nuclear imaging plays an important role in the diagnosis, staging, and management of thyroid cancer. The use of radioiodine imaging, thyroglobulin imaging, FDG imaging, and somatostatin receptor imaging are all valuable tools in the evaluation of thyroid cancer. With further research and development, nuclear imaging techniques have the potential to improve the diagnosis and management of thyroid cancer and other endocrine malignancies.

Keywords: Thyroid cancer, nuclear imaging, radioiodine imaging, fluorodeoxyglucose imaging, somatostatin receptor imaging, endocrine malignancy.

[1]
Cancer.Net. Thyroid Cancer - Statistics. 2012. Available from: https://www.cancer.net/cancer-types/thyroid-cancer/statistics(cited 2023 Apr 7)
[2]
Liu H, Wang X, Yang R, et al. Recent development of nuclear molecular imaging in thyroid cancer. BioMed Res Int 2018; 2018: 1-10.
[http://dx.doi.org/10.1155/2018/2149532] [PMID: 29951528]
[3]
Fu H, Sa R, Cheng L, et al. Updated review of nuclear molecular imaging of thyroid cancers. Endocr Pract 2021; 27(5): 494-502.
[http://dx.doi.org/10.1016/j.eprac.2020.10.001] [PMID: 33934754]
[4]
Brauckhoff K, Biermann M. Multimodal imaging of thyroid cancer. Curr Opin Endocrinol Diabetes Obes 2020; 27(5): 335-44.
[http://dx.doi.org/10.1097/MED.0000000000000574] [PMID: 32773568]
[5]
Heston TF, Wahl RL. Molecular imaging in thyroid cancer. Cancer Imaging 2010; 10(1): 1-7.
[http://dx.doi.org/10.1102/1470-7330.2010.0002] [PMID: 20159663]
[6]
Yavuz S, Puckett Y. Iodine-131 Uptake Study. Treasure Island, (FL): StatPearls 2022.
[7]
Larg M, Barbus E, Gabora K, Pestean C, Cheptea M, Piciu D. 18F-FDG PET/CT in differentiated thyroid carcinoma. Acta Endocrinol 2019; 15(2): 203-8.
[http://dx.doi.org/10.4183/aeb.2019.203] [PMID: 31508177]
[8]
Serfling SE, Zhi Y, Megerle F, et al. Somatostatin receptor-directed molecular imaging for therapeutic decision-making in patients with medullary thyroid carcinoma. Endocrine 2022; 78(1): 169-76.
[http://dx.doi.org/10.1007/s12020-022-03116-6] [PMID: 35751778]
[9]
Ambrosini V, Zanoni L, Filice A, et al. Radiolabeled somatostatin analogues for diagnosis and treatment of neuroendocrine tumors. Cancers 2022; 14(4): 1055.
[http://dx.doi.org/10.3390/cancers14041055] [PMID: 35205805]
[10]
Interventional Nuclear Medicine Scan Delhi NCR. Available from: https://www.rgcirc.org/diagnostics/department-of-nuclear-medicines/interventional-procedures/ (cited 2023 Apr 10)
[11]
Schlumberger M, Garcia C, Hadoux J, Klain M, Lamartina L. Functional imaging in thyroid cancer patients with metastases and therapeutic implications. Presse Med 1983; 51(2): 104113.
[12]
Goldsmith SJ. Radioactive iodine therapy of differentiated thyroid carcinoma: Redesigning the paradigm. Mol Imaging Radionucl Ther 2017; 26(1(S1)): 74-9.
[http://dx.doi.org/10.4274/2017.26.suppl.08] [PMID: 28117291]
[13]
Aqsa I, Anis R, Eds. Thyroid Uptake and Scan. Treasure Island, (FL): StatPearls 2022.
[14]
Grant FD, Treves ST. Thyroid. In: Treves S, Ed. Pediatric Nuclear Medicine and Molecular Imaging. New York, NY: Springer 2014; pp. 99-129.
[http://dx.doi.org/10.1007/978-1-4614-9551-2_5]
[15]
Tamhane S, Gharib H. Thyroid nodule update on diagnosis and management. Clin Diabetes Endocrinol 2016; 2(1): 17.
[http://dx.doi.org/10.1186/s40842-016-0035-7] [PMID: 28702251]
[16]
Yansong L. Internal radiation therapy: A neglected aspect of nuclear medicine in the molecular era. J Biomed Res 2015; 29(5): 345-55.
[http://dx.doi.org/10.7555/JBR.29.20140069] [PMID: 26445567]
[17]
Carballo M, Quiros RM. To treat or not to treat: The role of adjuvant radioiodine therapy in thyroid cancer patients. J Oncol 2012; 2012: 1-11.
[http://dx.doi.org/10.1155/2012/707156] [PMID: 23193402]
[18]
Van Nostrand D. Radioiodine imaging for differentiated thyroid cancer: Not all radioiodine images are performed equally. Thyroid 2019; 29(7): 901-9.
[http://dx.doi.org/10.1089/thy.2018.0690] [PMID: 31184275]
[19]
Manzil FFP, Kaur H. Radioactive Iodine for Thyroid Malignancies. Treasure Island, (FL): StatPearls 2022.
[20]
Nguyen QT, Lee EJ, Huang MG, Park YI, Khullar A, Plodkowski RA. Diagnosis and treatment of patients with thyroid cancer. Am Health Drug Benefits 2015; 8(1): 30-40.
[PMID: 25964831]
[21]
Sheikh A, Polack B, Rodriguez Y, Kuker R. Nuclear molecular and theranostic imaging for differentiated thyroid cancer. Mol Imaging Radionucl Ther 2017; 26(1(S1)): 50-65.
[http://dx.doi.org/10.4274/2017.26.suppl.06] [PMID: 28117289]
[22]
Wimmer I, Pichler R, Wimmer I, Pichler R. FDG PET in thyroid cancer. In: Thyroid Cancer - Advances in Diagnosis and Therapy. London: IntechOpen 2016.
[http://dx.doi.org/10.5772/64110]
[23]
Zhu A, Lee D, Shim H. Metabolic PET imaging in cancer detection and therapy response. Semin Oncol 2011; 38(1): 55-69.
[http://dx.doi.org/10.1053/j.seminoncol.2010.11.012] [PMID: 21362516]
[24]
Abelleira E, García Falcone MG, Bueno F, Pitoia F. Role of 18F-FDG-PET/CT in patients with differentiated thyroid cancer with biochemical incomplete or indeterminate response to treatment. Endocrinol Diabetes Nutr Engl Ed. 2020; 67: pp. (8)517-24.
[25]
Zampella E, Klain M, Pace L, Cuocolo A. PET/CT in the management of differentiated thyroid cancer. Diagn Interv Imaging 2021; 102(9): 515-23.
[http://dx.doi.org/10.1016/j.diii.2021.04.004] [PMID: 33926848]
[26]
Nanni C, Rubello D, Fanti S, et al. Role of 18F-FDG-PET and PET/CT imaging in thyroid cancer. Biomed Pharmacother 2006; 60(8): 409-13.
[http://dx.doi.org/10.1016/j.biopha.2006.07.008] [PMID: 16891093]
[27]
Araz M, Çayır D. 18F-fluorodeoxyglucose-positron emission tomography/computed tomography for other thyroid cancers: Medullary, anaplastic, lymphoma and so forth. Mol Imaging Radionucl Ther 2017; 26(1): 1-8.
[http://dx.doi.org/10.4274/mirt.60783] [PMID: 28291004]
[28]
Bal C, Chakraborty D, Khan D. Positron emission tomography/computed tomography in thyroid cancer. PET Clin 2022; 17(2): 265-83.
[http://dx.doi.org/10.1016/j.cpet.2021.12.004] [PMID: 35256297]
[29]
Hofman MS, Hicks RJ. How we read oncologic FDG PET/CT. Cancer Imaging 2016; 16(1): 35.
[http://dx.doi.org/10.1186/s40644-016-0091-3] [PMID: 27756360]
[30]
Garcia D, Singh V. Nuclear Medicine PET/CT Thyroid Cancer Assessment, Protocols, and Interpretation. Treasure Island, (FL): StatPearls 2022.
[31]
Choudhury PS, Gupta M. Differentiated thyroid cancer theranostics: Radioiodine and beyond. Br J Radiol 2018; 91(1091): 20180136.
[http://dx.doi.org/10.1259/bjr.20180136] [PMID: 30260232]
[32]
Liu Y. The role of 18F-FDG PET/CT in the follow-up of well-differentiated thyroid cancer with negative thyroglobulin but positive and/or elevated antithyroglobulin antibody. Nucl Med Commun 2016; 37(6): 577-82.
[http://dx.doi.org/10.1097/MNM.0000000000000480] [PMID: 26813991]
[33]
Kumar R, Sharma P, Singh H, Bal C. PET/CT imaging of neuroendocrine tumors with 68 Gallium-labeled somatostatin analogues: An overview and single institutional experience from India. Indian J Nucl Med 2014; 29(1): 2-12.
[http://dx.doi.org/10.4103/0972-3919.125760] [PMID: 24591775]
[34]
Lamberts SWJ, Reubi JC, Krenning EP. Somatostatin receptor imaging in the diagnosis and treatment of neuroendocrine tumors. J Steroid Biochem Mol Biol 1992; 43(1-3): 185-8.
[http://dx.doi.org/10.1016/0960-0760(92)90206-X] [PMID: 1356013]
[35]
Desai H, Borges-Neto S, Wong TZ. Molecular imaging and therapy for neuroendocrine tumors. Curr Treat Options Oncol 2019; 20(10): 78.
[http://dx.doi.org/10.1007/s11864-019-0678-6] [PMID: 31468190]
[36]
Tran K, Khan SR, Taghizadehasl M, Palazzo F, Frilling A, Todd J, et al. Gallium-68 Dotatate PET/CT is superior to other imaging modalities in the detection of medullary carcinoma of the thyroid in the presence of high serum calcitonin. Hell J Nucl Med 2015; 18(1): 19-24.
[37]
Hennrich U, Benešová M. [68Ga]Ga-DOTA-TOC: The first FDA-approved 68Ga-radiopharmaceutical for PET imaging. Pharmaceuticals 2020; 13(3): 38.
[http://dx.doi.org/10.3390/ph13030038] [PMID: 32138377]
[38]
Eychenne R, Bouvry C, Bourgeois M, Loyer P, Benoist E, Lepareur N. Overview of radiolabeled somatostatin analogs for cancer imaging and therapy. Molecules 2020; 25(17): 4012.
[http://dx.doi.org/10.3390/molecules25174012] [PMID: 32887456]
[39]
Fortunati E, Argalia G, Zanoni L, Fanti S, Ambrosini V. New PET radiotracers for the imaging of neuroendocrine neoplasms. Curr Treat Options Oncol 2022; 23(5): 703-20.
[http://dx.doi.org/10.1007/s11864-022-00967-z] [PMID: 35325412]
[40]
Quon A, Fischbein NJ, McDougall IR, et al. Clinical role of 18F-FDG PET/CT in the management of squamous cell carcinoma of the head and neck and thyroid carcinoma. J Nucl Med 2007; 48(1 (S1)): 58S-67S.
[PMID: 17204721]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy