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Comparison of 99mTc-HYNIC-TOC and HYNIC-TATE Octreotide Scintigraphy With FDG PET and 99mTc-MIBI in Local Recurrent or Distant Metastatic Thyroid Cancers

Sager, Sait MD*; Kabasakal, Levent MD*; Halac, Metin MD*; Maecke, Helmut PhD; Uslu, Lebriz MD*; Önsel, Çetin MD*; Kanmaz, Bedii MD*

doi: 10.1097/RLU.0b013e3182868062
Original Articles

Aim: There have been various studies for early diagnosis of local recurrent or distant metastatic thyroid cancers. The aim of this study is to evaluate the clinical utility of 99mTc-HYNIC-TOC and 99mTc-HYNIC-TATE, octreotide derivatives, to detect recurrences or distant metastases in 131I-negative thyroglobulin positive thyroid cancer patients and to compare the lesions with FDG PET and 99mTc-MIBI studies in the same patient group.

Patients and Methods: Twenty differentiated thyroid cancer patients, 7 male and 13 female, mean age 54.6 ± 15.3 (range 13–78 years), were included in this study. Eighteen patients had papillary thyroid cancer and 2 had follicular thyroid cancer. Fifteen patients received HYNIC-TOC and 5 patients received HYNIC-TATE as a radiopharmaceutical. All patients underwent whole-body scan 1 and 4 hours after injection of octreotide derivatives and SPECT imagings were performed from the suspicious sites. The lesions that were seen in 99mTc-HYNIC-TOC and 99mTc-HYNIC-TATE studies were compared with 99mTc-MIBI and FDG-PET studies.

Results: Among 99mTc-HYNIC-TOC and 99mTc-HYNIC-TATE scintigraphies, 15 patient studies were evaluated as true positive (75%) and 5 were false negative (25%). The total number of lesions in octreotide scintigraphy was 48 in 20 patients. Of 20 patients, 19 had FDG-PET study, 15 of them were evaluated as true positive (78.9%), and 4 them were evaluated as false negative (21.1%). Total number of lesions in FDG PET was 74. 99mTc-MIBI study was positive in 11 patients (55%) and negative in 9 patients (45%). Total number of lesions in 99mTc-MIBI was 25.

Conclusion: Technetium-labeled somatostatin receptor scintigraphy analogues HYNIC-TOC and HYNIC-TATE are useful imaging alternatives in somatostatin receptor expressing thyroid cancer patients. Radiolabeling is easy and they are readily available for routine use.

From the *Department of Nuclear Medicine, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey; and †Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany.

Received for publication May 8, 2012; and revision accepted December 29, 2012.

Conflicts of interest and sources of funding: none declared.

Reprints: Sait Sager, MD, Department of Nuclear Medicine, Cerrahpasa Medical Faculty, Istanbul University, Cerrahpasa, Fatih, Istanbul, Turkey. E-mail:

© 2013 by Lippincott Williams & Wilkins