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- W2034142439 abstract "Medullary thyroid cancer (MTC) is an uncommon and challenging malignancy. In spite of aggressive primary treatment with total thyroidectomy and modified neck lymph node dissection, approximately 50 % of the patients have persistent or recurrent disease [1, 2]. The recent European Thyroid Association guidelines [3] recommend surgery and other local treatment modalities (such as external beam radiation therapy, radiofrequency ablation, and chemoembolization) for the treatment of distant metastases in patients with low tumor burden (distant metastases limited to single organ) and stable disease, while patients with symptoms, significant tumor burden and progressive disease should receive novel targeted systemic therapies. However, imaging of recurrent disease in MTC is difficult and still poses a major problem in the management of the disease. The serum tumor markers calcitonin (Ct) and carcinoembryonic antigen (CEA) and their doubling times (Dt) are used to assess progression rate and also reflect tumor burden in MTC. However, conventional imaging (CI) is often negative in patients with Ct concentrations 150 pg/ mL [3]. It is estimated that CI identifies metastases in about 40 % of patients with biochemical evidence of recurrence. The probability of detecting metastases increases in patients with increasing Ct and CEA concentrations and shortening Dts. Of note, some patients with poorly differentiated and aggressive metastatic MTC have low Ct or discrepantly high CEA concentrations. The recommended CI protocol is extensive and comprises neck ultrasonography for detection of cervical lymph node metastases, computed tomography (CT) of thorax for lung and mediastinal lesions, magnetic resonance imaging (MRI) for liver and bone metastases of the spine and pelvis and bone scintigraphy. Modern whole body imaging with positron emission tomography (PET) and integrated CT could thus represent an alternative to CI, at least for patients with negative CI imaging." @default.
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- W2034142439 date "2012-07-14" @default.
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- W2034142439 title "Is there a role for fluorine-18 fluorodeoxyglucose positron emission tomography imaging in medullary thyroid cancer?" @default.
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- W2034142439 doi "https://doi.org/10.1007/s12020-012-9740-x" @default.
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