PET/CT imaging with radiolabeled FAPI: new opportunities for diagnosis and treatment of thyroid cancer

Excerpt

Differentiated thyroid cancer (DTC) represents the most frequent endocrine neoplasm, with an excellent prognosis [1]. After surgery, radioactive iodine (RAI) treatment remains a mainstay of therapy for these patients, and it is currently recommended in patients at intermediate or high risk of recurrence [1, 2]. However, a significant percentage of DTC patients with recurrence or metastasis lose the ability of taking up iodine initially or gradually, resulting RAI-refractory with a more aggressive behavior [3‐5]. On the other hand, patients with poorly differentiated tumors, high thyroglobulin values, and suspected metastases may also show an absence of iodine uptake at scintigraphy imaging [6, 7]. Therefore, in these patients, other imaging modalities are required in order to detect unknown foci of disease or monitor the efficacy of therapy. Hybrid imaging by positron emission tomography/computed tomography (PET/CT) is the most widely used nuclear imaging method for the evaluation of patients with oncological diseases [8‐13]. The tumor cells have the ability of consuming a large amount of glucose through aerobic glycolysis, a mechanism known as the Warburg Effect [14, 15]. Nowadays, [¹⁸F]FDG is the most widely used radiotracer in oncology [8‐13, 16]. …