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Nuclear Medicine
Oncology
Neuroendocrine
Medullary Thyroid Carcinoma
Medullary Thyroid Carcinoma
Ashley C. Mays, MD; Paige Bennett, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Definitions

          • Medullary thyroid carcinoma (MTC): Rare neuroendocrine malignancy arising from thyroid parafollicular C cells (which secrete calcitonin)
            • Thyroidectomy with extensive nodal dissection may be curative
            • Serum calcitonin levels monitored as persistent disease and recurrence common
            • Imaging important when serum calcitonin levels rise to detect potentially resectable recurrent/metastatic disease

        IMAGING

        • Ga-68 Dotatate PET/CT Findings

          • F-18 FDG PET/CT Findings

            • Other Nuclear Medicine Modality Findings

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Rodríguez-Bel L et al: Diagnostic accuracy of 18F-FDG PET/CT in patients with biochemical evidence of recurrent, residual, or metastatic medullary thyroid carcinoma. Clin Nucl Med. 44(3):194-200, 2019
                                        2. Duarte PS et al: Bone and calcified soft tissue metastases of medullary thyroid carcinoma better characterized on 18F-fluoride PET/CT than on 68Ga-dotatate PET/CT. Nucl Med Mol Imaging. 52(4):318-23, 2018
                                        3. Yamaga LYI et al: 68Ga-DOTATATE PET/CT in recurrent medullary thyroid carcinoma: a lesion-by-lesion comparison with 111In-octreotide SPECT/CT and conventional imaging. Eur J Nucl Med Mol Imaging. 44(10):1695-701, 2017
                                        4. De Luca S et al: Multimodal imaging with (18)F-FDG-PET/CT and (111)In-octreotide SPECT in patients with metastatic medullary thyroid carcinoma. Ann Nucl Med. 30(3):234-41, 2016
                                        5. Kelil T et al: Current concepts in the molecular genetics and management of thyroid cancer: An update for radiologists. Radiographics. 36(5):1478-93, 2016
                                        6. Delorme S et al: Medullary thyroid carcinoma: Imaging. Recent Results Cancer Res. 204:91-116, 2015
                                        7. Makis W et al: Medullary thyroid carcinoma (MTC) treated with 177Lu-DOTATATE PRRT: a report of two cases. Clin Nucl Med. 40(5):408-12, 2015
                                        8. Tran K 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. 18(1):19-24, 2015
                                        9. Khan N et al: Review of fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in the follow-up of medullary and anaplastic thyroid carcinomas. Cancer Control. 12(4):254-60, 2005
                                        10. de Groot JW et al: Impact of 18F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in patients with biochemical evidence of recurrent or residual medullary thyroid cancer. Ann Surg Oncol. 11(8):786-94, 2004
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Definitions

                                                • Medullary thyroid carcinoma (MTC): Rare neuroendocrine malignancy arising from thyroid parafollicular C cells (which secrete calcitonin)
                                                  • Thyroidectomy with extensive nodal dissection may be curative
                                                  • Serum calcitonin levels monitored as persistent disease and recurrence common
                                                  • Imaging important when serum calcitonin levels rise to detect potentially resectable recurrent/metastatic disease

                                              IMAGING

                                              • Ga-68 Dotatate PET/CT Findings

                                                • F-18 FDG PET/CT Findings

                                                  • Other Nuclear Medicine Modality Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Ultrasonographic Findings

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Staging, Grading, & Classification

                                                                • Gross Pathologic & Surgical Features

                                                                  • Microscopic Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Rodríguez-Bel L et al: Diagnostic accuracy of 18F-FDG PET/CT in patients with biochemical evidence of recurrent, residual, or metastatic medullary thyroid carcinoma. Clin Nucl Med. 44(3):194-200, 2019
                                                                              2. Duarte PS et al: Bone and calcified soft tissue metastases of medullary thyroid carcinoma better characterized on 18F-fluoride PET/CT than on 68Ga-dotatate PET/CT. Nucl Med Mol Imaging. 52(4):318-23, 2018
                                                                              3. Yamaga LYI et al: 68Ga-DOTATATE PET/CT in recurrent medullary thyroid carcinoma: a lesion-by-lesion comparison with 111In-octreotide SPECT/CT and conventional imaging. Eur J Nucl Med Mol Imaging. 44(10):1695-701, 2017
                                                                              4. De Luca S et al: Multimodal imaging with (18)F-FDG-PET/CT and (111)In-octreotide SPECT in patients with metastatic medullary thyroid carcinoma. Ann Nucl Med. 30(3):234-41, 2016
                                                                              5. Kelil T et al: Current concepts in the molecular genetics and management of thyroid cancer: An update for radiologists. Radiographics. 36(5):1478-93, 2016
                                                                              6. Delorme S et al: Medullary thyroid carcinoma: Imaging. Recent Results Cancer Res. 204:91-116, 2015
                                                                              7. Makis W et al: Medullary thyroid carcinoma (MTC) treated with 177Lu-DOTATATE PRRT: a report of two cases. Clin Nucl Med. 40(5):408-12, 2015
                                                                              8. Tran K 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. 18(1):19-24, 2015
                                                                              9. Khan N et al: Review of fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in the follow-up of medullary and anaplastic thyroid carcinomas. Cancer Control. 12(4):254-60, 2005
                                                                              10. de Groot JW et al: Impact of 18F-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in patients with biochemical evidence of recurrent or residual medullary thyroid cancer. Ann Surg Oncol. 11(8):786-94, 2004