Comparison of 18F-DOPA, 18F-FDG and 68Ga-somatostatin analogue PET/CT in patients with recurrent medullary thyroid carcinoma

Eur J Nucl Med Mol Imaging. 2012 Apr;39(4):569-80. doi: 10.1007/s00259-011-2031-6. Epub 2012 Jan 6.


Purpose: To retrospectively evaluate and compare (18)F-FDG, (18)F-DOPA and (68)Ga-somatostatin analogues for PET/CT in patients with residual/recurrent medullary thyroid carcinoma (MTC) suspected on the basis of elevated serum calcitonin levels.

Methods: Included in the study were 18 patients with recurrent MTC in whom functional imaging with the three tracers was performed. The PET/CT results were compared on a per-patient basis and on a per-lesion-basis.

Results: At least one focus of abnormal uptake was observed on PET/CT in 13 patients with (18)F-DOPA (72.2% sensitivity), in 6 patients with (68)Ga-somatostatin analogues (33.3%) and in 3 patients with (18)F-FDG (16.7%) (p < 0.01). There was a statistically significant difference in sensitivity between (18)F-DOPA and (18)F-FDG PET/CT (p < 0.01) and between (18)F-DOPA and (68)Ga-somatostatin analogue PET/CT (p = 0.04). Overall, 72 lesions were identified on PET/CT with the three tracers. (18)F-DOPA PET/CT detected 85% of lesions (61 of 72), (68)Ga-somatostatin analogue PET/CT 20% (14 of 72) and (18)F-FDG PET/CT 28% (20 of 72). There was a statistically significant difference in the number of lymph node, liver and bone lesions detected with the three tracers (p < 0.01). In particular, post-hoc tests showed a significant difference in the number of lymph node, liver and bone lesions detected by (18)F-DOPA PET/CT and (18)F-FDG PET/CT (p < 0.01 for all the analyses) and by (18)F-DOPA PET/CT and (68)Ga-somatostatin analogue PET/CT (p < 0.01 for all the analyses). The PET/CT results led to a change in management of eight patients (44%).

Conclusion: (18)F-DOPA PET/CT seems to be the most useful imaging method for detecting recurrent MTC lesions in patients with elevated serum calcitonin levels, performing better than (18)F-FDG and (68)Ga-somatostatin analogue PET/CT. (18)F-FDG may complement (18)F-DOPA in patients with an aggressive tumour.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Calcitonin / blood
  • Carcinoma, Neuroendocrine
  • Dihydroxyphenylalanine / analogs & derivatives*
  • Female
  • Fluorodeoxyglucose F18*
  • Gallium Radioisotopes
  • Humans
  • Male
  • Middle Aged
  • Multimodal Imaging / methods*
  • Positron-Emission Tomography*
  • Precision Medicine
  • Recurrence
  • Retrospective Studies
  • Somatostatin / analogs & derivatives*
  • Thyroid Neoplasms / blood
  • Thyroid Neoplasms / diagnostic imaging*
  • Tomography, X-Ray Computed*


  • Gallium Radioisotopes
  • Fluorodeoxyglucose F18
  • fluorodopa F 18
  • Somatostatin
  • Dihydroxyphenylalanine
  • Calcitonin

Supplementary concepts

  • Thyroid cancer, medullary