{Reference Type}: Case Reports
{Title}: Can 99 Tc m -3PRGD 2 (α ν β 3 ) and 18 F-FDG dual-tracer molecular imaging change the therapeutic strategy for progressive refractory differentiated thyroid cancer: Case report.
{Author}: Zhang Y;Li Y;Lin Z;Chen W;
{Journal}: Medicine (Baltimore)
{Volume}: 102
{Issue}: 5
{Year}: Feb 2023 3
{Factor}: 1.817
{DOI}: 10.1097/MD.0000000000032751
{Abstract}: BACKGROUND: The management of radioiodine refractory differentiated thyroid cancer (RAIR-DTC) represents a major challenge in thyroid cancer. The American Thyroid Association guidelines recommend the use of tyrosine kinase inhibitors (TKIs) for RAIR-DTC that does not respond to conventional treatment. Currently, imaging modalities that predict the response to TKI treatment based on morphological and functional features are lacking. we report a case of a patient with progressive RAIR lung metastases who underwent 2-deoxy-2-[ 18 F]fluoro-D-glucose and 99technetiumm-three polyethylene glycol spacers-arginine-glycine-aspartic acid ( 99 Tc m -3PRGD 2 ) dual-tracer imaging and investigate the value of this imaging strategy for determining subsequent therapeutic schedules.
METHODS: A 52-year-old man with advanced RAIR-DTC and progressive lung metastasis. After TKI treatment [sorafenib] lost its clinical benefits, the patient's therapeutic response was evaluated as progressive disease. 2-deoxy-2-[ 18 F]fluoro-D-glucose PET/CT and 99 Tc m -3PRGD 2 SPECT/CT were performed. There were multiple FDG-positive lesions in the lung. However, 99 Tc m -3PRGD 2 SPECT/CT showed only 1 lesion in the right middle pulmonary lobe with arginine-glycine-aspartic positivity.
METHODS: RAIR-DTC.
METHODS: Radiofrequency ablation was performed for only the lesion with RDG and FDG positivity.
RESULTS: The patient quickly achieved partial response.
CONCLUSIONS: This case indicates that for progressive RAIR metastases, patients can benefit more from prioritizing treatment for lesions that are both arginine-glycine-aspartic and FDG positive.