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

Sophie C Kunte; Vera Wenter; Johannes Toms; Simon Lindner; Marcus Unterrainer; Friederike Eilsberger; Klaus Jurkschat; Carmen Wängler; Björn Wängler; Ralf Schirrmacher; Maximilian W Tiling; Gabriel T Sheikh; Dirk Mehrens; Matthias Brendel; Johannes Rübenthaler; Christoph J Auernhammer; Christine Spitzweg; Lena M Unterrainer; Adrien Holzgreve

doi:10.1007/s00259-024-06944-y

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

Eur J Nucl Med Mol Imaging. 2024 Oct 15. doi: 10.1007/s00259-024-06944-y. Online ahead of print.

Authors

Sophie C Kunte¹, Vera Wenter¹, Johannes Toms¹, Simon Lindner¹, Marcus Unterrainer^{1

2}, Friederike Eilsberger³, Klaus Jurkschat⁴, Carmen Wängler^{5

6}, Björn Wängler^{6

7}, Ralf Schirrmacher⁸, Maximilian W Tiling¹, Gabriel T Sheikh¹, Dirk Mehrens⁹, Matthias Brendel^{1

10

11

12}, Johannes Rübenthaler⁹, Christoph J Auernhammer¹³, Christine Spitzweg¹³, Lena M Unterrainer^#^{1

14

15}, Adrien Holzgreve^#^{16

17}

Affiliations

¹ Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
² DIE RADIOLOGIE, Munich, Germany.
³ Department of Nuclear Medicine, School of Medicine, Philipps University Marburg, Marburg, Germany.
⁴ Fakultät für Chemie und Chemische Biologie, Technische Universität Dortmund, Dortmund, Germany.
⁵ Biomedical Chemistry, Clinic of Radiology and Nuclear Medicine, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
⁶ Research Campus M²OLIE, Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany.
⁷ Medical Faculty Mannheim of Heidelberg University, Molecular Imaging and Radiochemistry, Clinic of Radiology and Nuclear Medicine, Mannheim, Germany.
⁸ Department of Oncology, Division of Oncological Imaging, University of Alberta, Edmonton, AB, Canada.
⁹ Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany.
¹⁰ DZNE - German Center for Neurodegenerative Diseases, Munich, Germany.
¹¹ Munich Cluster for Systems Neurology (SyNergy), University of Munich, Munich, Germany.
¹² German Cancer Consortium (DKTK), Partner Site Munich, a Partnership Between DKFZ and Ludwig-Maximilians-Universität München (LMU), Munich, Germany.
¹³ Department of Internal Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany.
¹⁴ Ahmanson Translational Theranostics Division, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
¹⁵ Bayerisches Zentrum für Krebsforschung (BZKF), Partner Site Munich, Munich, Germany.
¹⁶ Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany. [email protected].
¹⁷ Ahmanson Translational Theranostics Division, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. [email protected].

^# Contributed equally.

PMID: 39404789
DOI: 10.1007/s00259-024-06944-y

Abstract

Purpose: 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.

Methods: 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).

Results: 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.

Conclusion: 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.

Keywords: (4–6): Medullary thyroid carcinoma (MTC); Differentiated thyroid carcinoma (DTC); Follicular thyroid carcinoma (FTC); Papillary thyroid carcinoma (PTC); Serum tumor marker; Somatostatin receptor (SSTR).