Iranian Journal of Nuclear Medicine

Iranian Journal of Nuclear Medicine

Detection of osseous metastasis by [68Ga]Ga-FAPI PET/CT in a thyroid cancer patient with elevated thyroglobulin and negative radioiodine scintigraphy

Document Type : Case Report

Authors
Atena Aghaee 1
Somaye Barashki 1
Amir Hossein Jafarian 2
Seyed Rasoul Zakavi 1
Hassan Kamali 3
Nasim Norouzbeigi 4
Kamran Aryana 1
1 Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
2 Department of Pathology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
3 Chemistry Department, Kharazmi University, Tehran, Iran
4 Nuclear Medicine Department, Razavi Hospital, Mashhad, Iran
10.22034/irjnm.2022.40051
Abstract
Thyroglobulin elevated-negative iodine scintigraphy (TENIS) differentiated thyroid cancer (DTC) patients are a subgroup of DTC patients with almost rapid disease progression and reduced overall survival and them usually do not have an effective treatment modality. Surgery and metastatectomy is the best option for recurrent disease in cases of solitary or oligometastasis. Detection of the metastatic sites is of utmost importance in these patients. We present a patient with TENIS syndrome and negative [18F]FDG PET/CT and [68Ga]Ga-DOTATATE whole body PET/CT scan in whom just [68Ga]Ga-FAPI PET/CT helped in localizing the metastatic lesion to the iliac bone and subsequently the bone metastasis was resected and the pathology report confirmed the diagnosis.
Keywords
[68Ga]Ga-FAPI PET/CT
TENIS syndrome
[18F]FDG PET/CT
Differentiated thyroid cancer
Subjects
  1. Kratochwil C, Flechsig P, Lindner T, Abderrahim L, Altmann A, Mier W, Adeberg S, Rathke H, Röhrich M, Winter H, Plinkert PK. 68Ga-FAPI PET/CT: tracer uptake in 28 different kinds of cancer. J Nucl Med. 2019 Jun 1;60(6):801-5.
  2. Treglia G, Muoio B, Roustaei H, Kiamanesh Z, Aryana K, Sadeghi R. Head-to-Head Comparison of Fibroblast Activation Protein Inhibitors (FAPI) Radiotracers versus [18F] F-FDG in Oncology: A Systematic Review. Int J Mol Sci. 2021 Oct 17;22(20):11192.
  3. Silberstein EB. The problem of the patient with thyroglobulin elevation but negative iodine scintigraphy: the TENIS syndrome. Semin Nucl Med. 2011 Mar 1;41(2):113-20
  4. Sfar R, Kamoun T, Nouira M, Regaieg H, Ammar N, Charfi H, Bahloul A, Fredj MB, Chatti K, Guezguez M, Essabbah H. Differentiated thyroid cancer with thyroglobulin elevation and negative iodine scintigraphy (TENIS syndrome). Int J Otorhinolaryngol Head Neck Surg. 2014 Jun 27;3: 149-53
  5. Fu H, Fu J, Huang J, Pang Y, Chen H. 68Ga-FAPI PET/CT versus 18F-FDG PET/CT for detecting metastatic lesions in a case of radioiodine-refractory differentiated thyroid cancer. Clin Nucl Med. 2021 Nov 1;46(11):940-2.
  6. Fu H, Fu J, Huang J, Su X, Chen H. 68Ga-FAPI PET/CT in thyroid cancer with thyroglobulin elevation and negative iodine scintigraphy. Clin Nucl Med. 2021 May 1;46(5):427-30.
  7. Jois B, Asopa R, Basu S. Somatostatin receptor imaging in non–131I-avid metastatic differentiated thyroid carcinoma for determining the feasibility of peptide receptor radionuclide therapy with 177Lu-DOTATATE: low fraction of patients suitable for peptide receptor radionuclide therapy and evidence of Chromogranin a level–positive neuroendocrine differentiation. Clin Nucl Med. 2014 Jun 1;39(6):505-10.
  8. Laursen R, Wehland M, Kopp S, Pietsch J, Infanger M, Grosse J, Grimm D. Effects and role of multikinase inhibitors in thyroid cancer. Curr Pharm Des. 2016 Nov 1;22(39):5915-26.
Iranian Journal of Nuclear Medicine
Volume 31, Issue 1 - Serial Number 60
January 2023
Pages 109-111