The utility of 68Ga-DOTATATE and 18F-FDG PET/CT in predicting the response to tyrosine kinase inhibitors in patients with advanced medullary thyroid cancer

作者：Eline C. Jager, James W. McNeil, Alexander Papachristos, Mark Sywak, Stan B. Sidhu, Rhonda Siddall, Jeremy Hoang, Geoffrey Schembri, Venessa Tsang, Ayanthi Wijewardene, Lyndal Tacon, Bruce Robinson, Roderick Clifton‐Bligh, Martyn Bullock, Adrienne H. Brouwers, Thera P. Links, Schelto Kruijff, Anthony Glover, Matti L. Gild · 发表于：Thyroid Research · 年份：2025 · DOI：10.1186/s13044-025-00250-x · 被引用次数：3 · 研究领域：Thyroid Cancer Diagnosis and Treatment、Neuroendocrine Tumor Research Advances、Radiopharmaceutical Chemistry and Applications

Abstract Background Tyrosine kinase inhibitors (TKIs) have significantly improved the prognosis of patients with advanced medullary thyroid cancer (MTC). However, treatment response heterogeneity leads to challenges in predicting individual favourable response. This study evaluated the correlation between PET metrics on 68 Ga-DOTATATE and 18 F-FDG PET/CTs prior to treatment, and TKI response. Methods This study retrospectively evaluated patients with metastatic MTC who received TKIs at a tertiary care hospital and had prior 68 Ga-DOTATATE and/or 18 F-FDG PET/CT imaging. Patient demographics, treatment and PET/CT data were collected. Standardized Uptake Value (SUV) max, SUVmean, Total Lesion Activity (TLA) and Metabolic Tumor Volume (MTV) were determined per PET/CT. Results In the 25 patients, mean age at diagnosis was 48 (±15) years; 11 (44%) were female and 21 tumors harbored RET driver alterations. Thirty-six TKI treatments were administered (11 patients received two TKIs sequentially). RECIST response rates (available in 32/36 treatments) included; stable disease in 8/32 (25%), partial response in 23/32 (72%) and complete response in 1/32 (3%) treatments. In total, 30 pre-TKI PET/CTs (24 68 Ga-DOTATATE PET/CTs, 6 18 F-FDG PET/CTs) were performed. Pre-TKI 68 Ga-DOTATATE PET/CTs did not correlate with TKI treatment response. In the 18 F-FDG cohort, high MTV and TLA correlated with a better structural response ( p < 0.001) and high SUVmean correlated with a longer time to ...