PET/CT imaging of differentiated and medullary thyroid carcinoma using the novel SSTR-targeting peptide [¹⁸F]SiTATE - first clinical experiences.

Abstract

The novel ¹⁸F-labeled somatostatin receptor (SSTR)-directed radiotracer [¹⁸F]SiTATE demonstrated promising results for the imaging of various SSTR-expressing tumor types. Although thyroid carcinomas (TC) express SSTR, data on [¹⁸F]SiTATE PET/CT imaging in TC are lacking. This study explores the use of [¹⁸F]SiTATE PET/CT in a patient cohort with histologically proven TC. As part of a prospective observational study at a single tertiary cancer center, 21 patients with TC (10 medullary (MTC) and 11 differentiated (DTC)) who underwent at least one [¹⁸F]SiTATE PET/CT were included (37 scans in total). Mean SUV_max and SUV_mean of tumoral lesions, mean total-tumor-volume (TTV), and whole-body (WB)-SUV_max and WB-SUV_mean on PET with their standard deviations (SDs) were determined. PET parameters were correlated to clinical parameters including tumor marker levels (thyroglobulin for DTC, calcitonin for MTC). 89 lesions were included in the analysis. Metastases were localized in the bone, lymph nodes, lung, soft tissue, and thyroid bed. Osseous (31 lesions; SUV_max 8.6 ± 8.0; SUV_mean 5.8 ± 5.4) and nodal (37 lesions; SUV_max 8.7 ± 7.8; SUV_mean 5.7 ± 5.4) metastases showed the highest uptake. The MTC disease burden on PET significantly correlated with the calcitonin tumor marker level (e.g., TTV: r = 0.771, r² = 0.594, p = 0.002). For DTC, no such correlation was present. Our data demonstrate high feasibility of [¹⁸F]SiTATE PET/CT in a small cohort of patients with MTC and DTC. The use of [¹⁸F]SiTATE may overcome logistical disadvantages of ⁶⁸Ga-based tracers and facilitate SSTR-targeted PET/CT imaging of thyroid carcinoma.