Somatostatin scans can detect recurrent or metastatic tumor in
patients with thyroid carcinoma
(July 2004)
The background of the study. Patients with thyroid
carcinoma are often evaluated by whole-body radioiodine scans. However,
in some patients these scans are negative. Some thyroid carcinomas
contain receptors for somatostatin (a small brain hormone) and therefore
may be visualized by scans done after the administration of radiolabeled
analogs of somatostatin.
How the study was done. The somatostatin analog
octreotide, labeled with radioactive indium, was administered to
43 patients with thyroid carcinoma who had high serum thyroglobulin
concentrations (evidence of recurrent cancer) and negative radioiodine
scans. They had been treated by total thyroidectomy and radioiodine
1 to 23 years earlier. In addition to the octreotide scans, chest
x-rays and ultrasonography of the neck were done in all patients,
and computed tomography (CT) or magnetic resonance (MR) scans of
the neck, chest, or abdomen were done in most patients.
The results of the study. Thirty-three patients
(77 percent) had a local recurrence or one or more distant metastases
of their carcinoma, as detected by one or more of the imaging tests
and confirmed by pathologic examination. The octreotide scan was
positive in 22 patients (51 percent), and it was the only positive
scan in 3 patients (7 percent). Thirty patients (70 percent) had
positive chest x-ray, neck ultrasonographic, and CT or MR scans.
The carcinoma was in the neck in 15 patients, mediastinum in 18,
lungs in 17, bone in 5, and abdomen in 4.
The conclusions of the study. Octreotide scans
reveal recurrent or metastatic thyroid carcinoma in some patients
who have high serum thyroglobulin concentrations and negative whole-body
radioiodine scan.
The original article. Giammarile F, Houzard C,
Bournaud C, Hafdi Z, Sassolas G, Borson-Chazot F. Diagnostic management
of suspected metastatic thyroid carcinoma: clinical value of octreotide
scintigraphy in patients with negative high-dose radioiodine scans.
Eur J Endocrinol 2004;150:277-83.
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