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Detection of recurrence from medullary thyroid carcinoma (MTC) remains a diagnostic problem, especially when increased serum tumour marker levels suggest recurrence and conventional imaging techniques are non-diagnostic. In this study, we performed ¹¹¹In-octreotide and ^99mTc(V)-dimercaptosuccinic acid (DMSA) scans in a series of eleven patients with MTC presenting with elevated serum tumour markers after surgery.

¹¹¹In-octreotide whole body studies detected tumour in six of the eleven patients studied and detected nine tumoral localizations. ^99mTc(V)-DMSA whole body studies detected tumour in five of the eleven patients studied and eight tumoral localizations. ¹¹¹In-octreotide and ^99mTc(V)-DMSA studies detected recurrence in all four patients with basal calcitonin levels above 1000 ng/l. We conclude that ¹¹¹In-octreotide and ^99mTc(V)-DMSA studies have limited sensitivity to detect recurrence in patients with MTC, although their sensitivity may improve with high serum calcitonin levels. These radionuclide imaging techniques should be employed when conventional imaging techniques are negative or inconclusive or, in the case of ¹¹¹In-octreotide studies, should be employed when we want to investigate the presence of somatostatin receptors that provide the basis for treatment with somatostatin analogues.

Journal of Endocrinology (1995) 144, 339–345

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