Prostate-specific Membrane Antigen Imaging in Recurrent Medullary Thyroid Cancer: A New Theranostic Tracer in the Offing?

Saurabh Arora; Meghana Prabhu; Nishikant Avinash Damle; Chandrasekhar Bal; Praveen Kumar; Harish Nalla; Sreedharan Thankarajan Arun Raj

doi:10.4103/ijnm.IJNM_10_18

Prostate-specific Membrane Antigen Imaging in Recurrent Medullary Thyroid Cancer: A New Theranostic Tracer in the Offing?

Indian J Nucl Med. 2018 Jul-Sep;33(3):261-263. doi: 10.4103/ijnm.IJNM_10_18.

Authors

Saurabh Arora¹, Meghana Prabhu¹, Nishikant Avinash Damle¹, Chandrasekhar Bal¹, Praveen Kumar¹, Harish Nalla¹, Sreedharan Thankarajan Arun Raj¹

Affiliation

¹ Department of Nuclear Medicine, AIIMS, New Delhi, India.

Abstract

Prostate-specific membrane antigen (PSMA) expression has been shown in neovasculature of various malignancies. Recurrent medullary thyroid cancer (MTC) is difficult to treat. We present the findings on PSMA-positron emission tomography/computed tomography (PET/CT) of a 68-year-old man with MTC, who presented with a recurrent left paratracheal mass and rising calcitonin. The scan revealed significant uptake on PSMA imaging but not on ⁶⁸Ga-DOTANOC PET/CT. ¹⁷⁷Lu-PRRT is one of the therapeutic options in patients with recurrent MTC, but in this case was not possible due to lack of somatostatin receptor expression. Imaging evidence of PSMA expression alerts us to the potential use of ¹⁷⁷Lu-DKFZ-PSMA-617 therapy in such patients.

Keywords: 68Ga-DOTANOC; 68Ga-prostate-specific membrane antigen; medullary thyroid carcinoma; positron emission tomography/computed tomography.