Searches
/
Recent Results In Cancer Research. Fortschritte Der Krebsforschung. Progres Dans Les Recherches Sur Le Cancer[JOURNAL]
Recent Results In Cancer Research. Fortschritte Der Krebsforschung. Progres Dans Les Recherches Sur Le Cancer[JOURNAL]
Sun
200 papers
Preclinical PET, PET/CT, and PET/MRI.
Schelhaas S, Schäfers M
Recent Results Cancer Res · 2026 · PMID 42149190 · Publisher ↗
As tumors represent one of the most common causes of death in developed countries, it is of utmost importance to understand the (molecular) mechanisms underlying tumor progression. On this basis, cancer diagnosis and the...
As tumors represent one of the most common causes of death in developed countries, it is of utmost importance to understand the (molecular) mechanisms underlying tumor progression. On this basis, cancer diagnosis and therapy can be improved. Specific radioactive molecules can help in providing such information when detected by sensitive cameras, especially when this is done in a three-dimensional manner. Positron-emitting radioisotopes can be detected by positron emission tomography (PET) cameras. A range of molecular processes can be visualized by PET, depending on the radiotracer used. However, before novel tracers can be used in a clinical scenario, it is fundamental to thoroughly prove their specificity in in vitro experiments and also in animal models. And also tracers, which are already clinically used, may be further validated in preclinical studies. To this end, small animal models of cancer and also dedicated preclinical PET cameras have been developed. Preclinical PET, in combination with CT or MRI, has fundamentally contributed to the establishment of novel imaging, diagnostic, therapy and theranostic approaches in the clinics. Here, we provide an overview of the diverse applications and also the challenges of preclinical PET in the field of oncology.
Optical and Photoacoustic Imaging.
Napp J, Markus A, Alves F
Recent Results Cancer Res · 2026 · PMID 42149189 · Publisher ↗
Optical imaging is crucial in preclinical evaluation of tumor development, progression, and therapies, due to its low cost, versatility, sensitivity, and capability of real-time monitoring. The main in vivo imaging techn...
Optical imaging is crucial in preclinical evaluation of tumor development, progression, and therapies, due to its low cost, versatility, sensitivity, and capability of real-time monitoring. The main in vivo imaging techniques include fluorescence, bioluminescence, and photoacoustic imaging. Although all three applications are limited by relatively low tissue penetration due to absorption and scattering of light in biological tissues, each application has its own benefits. Fluorescence imaging is technically the simplest method to perform and using near infrared fluorescent (NIRF) probes can enhance depth capability. Moreover, novel activatable probes, lifetime imaging, and multimodal imaging strategies have extended its utility to endoscopic and surgical procedures. Bioluminescence imaging boasts high sensitivity and signal-to-noise ratio, as light emission originates at the target from enzymatic reactions. However, it requires genetic modification to express luciferases, restricting its use in humans. Photoacoustic imaging offers better depth penetration compared to purely optical methods by utilizing ultrasound signals. Leveraging endogenous contrast from chromophores, it assists in vascular imaging and tumor identification without external labels. Due to the use of safe, non-ionizing radiation, it reduces the risk to subjects and allows repeated imaging, and is thus most suited for clinical translation. All three applications continuously benefit from the development of three-dimensional imaging techniques and deep learning algorithms.
Preclinical Applications of Magnetic Resonance Imaging in Oncology.
Reichardt W, Schmidt AB, von Elverfeldt D
Recent Results Cancer Res · 2026 · PMID 42149188 · Publisher ↗
The evolving possibilities of molecular imaging (MI) are fundamentally changing the way we look at cancer, with imaging paradigms now shifting away from basic morphological measures toward the longitudinal assessment of...
The evolving possibilities of molecular imaging (MI) are fundamentally changing the way we look at cancer, with imaging paradigms now shifting away from basic morphological measures toward the longitudinal assessment of functional, metabolic, cellular, and molecular information in vivo. Recent developments of imaging methodology and probe molecules utilizing the vast number of novel animal models of human cancers have enhanced our ability to non-invasively characterize neoplastic tissue, the tumor microenvironment (TME), and follow anticancer treatments. While preclinical molecular imaging offers a wide spectrum of excellent methodologies to choose from, we will focus on magnetic resonance imaging (MRI) techniques, since they provide excellent molecular imaging capabilities and bear high potential for clinical translation. Prerequisites and consequences of using animal models as surrogates of human cancers in preclinical molecular imaging are outlined. We present physical principles, values, and limitations of MRI as a molecular imaging modality and comment on its high potential to non-invasively assess information on metabolism, hypoxia, supporting cancer tissue, and cell trafficking in preclinical cancer research.
Pre-clinical SPECT and SPECT-CT in Oncology.
Seo Y, Zannoni EM
Recent Results Cancer Res · 2026 · PMID 42149187 · Publisher ↗
Molecular imaging enables both spatial and temporal understanding of the complex biological systems underlying carcinogenesis and malignant spread. Single photon emission computed tomography (SPECT) is a versatile nuclea...
Molecular imaging enables both spatial and temporal understanding of the complex biological systems underlying carcinogenesis and malignant spread. Single photon emission computed tomography (SPECT) is a versatile nuclear imaging technique with ideal properties to study these processes in vivo in small animal models, as well as to identify potential drug candidates, characterize their anti-tumor action, and potential adverse effects.Small-animal SPECT, SPECT-CT (combined with computed tomography), and SPECT-MR (combined with magnetic resonance imaging) systems continue to evolve, as do the numerous radiopharmaceuticals that can be imaged by SPECT, allowing unprecedented sensitivity and quantitative molecular imaging capabilities. Several of these advances, their specific applications in oncology as well as new areas of exploration are highlighted in this chapter.
Artificial Intelligence and Radiomics in Molecular Oncology Imaging.
Truhn D, Nebelung S
Recent Results Cancer Res · 2026 · PMID 42149186 · Publisher ↗
In this chapter, we explore the landscape of artificial intelligence and radiomics in molecular oncology imaging. Advances in molecular imaging methods offer powerful insights into tumor biology but generate complex data...
In this chapter, we explore the landscape of artificial intelligence and radiomics in molecular oncology imaging. Advances in molecular imaging methods offer powerful insights into tumor biology but generate complex data beyond the capability of traditional visual interpretation alone. To address this complexity, radiomics emerged as a structured method to quantify imaging features, transforming subtle textures and tumor shapes into meaningful biomarkers. More recently, deep learning approaches-particularly convolutional neural networks-have taken this concept further, automatically learning intricate patterns directly from imaging data. Additionally, we introduce transformer architectures, a newer AI approach, capable of capturing global image context and integrating imaging information seamlessly with other clinical data. Throughout, we discuss the strengths and limitations of each method, highlighting challenges such as large data requirements, standardization, interpretability, and rigorous validation needed for clinical translation. Finally, we emphasize emerging techniques, such as self-supervised and multimodal learning, which promise to overcome these limitations and push molecular imaging toward genuinely personalized cancer care.
Optical and Optoacoustic Imaging Probes.
Eisenblätter M, Wildgruber M
Recent Results Cancer Res · 2026 · PMID 42149185 · Publisher ↗
Tissue has characteristic properties when it comes to light absorption and scattering. For optical (OI) and optoacoustic imaging (OAI) these properties can be utilised to visualise endogenous chromophores, such as the ox...
Tissue has characteristic properties when it comes to light absorption and scattering. For optical (OI) and optoacoustic imaging (OAI) these properties can be utilised to visualise endogenous chromophores, such as the oxygenation state of haemoglobin or melanin, as well as exogenously applied optical probes. Optical probes convert the energy of the light, typically laser, into either light of different wavelength, suited especially for fluorescent probes, or rather convert the energy into thermal expansion, favourable for optoacoustic imaging.
Microbubble Contrast Agents for Molecular Ultrasound Imaging of Tumor Vasculature.
Klibanov AL
Recent Results Cancer Res · 2026 · PMID 42149184 · Publisher ↗
Molecular ultrasound imaging was proposed more than two decades ago. The ultrasound contrast agents used for selective targeting of vascular biomarkers of disease are formulated as gas microbubbles surrounded by a thin s...
Molecular ultrasound imaging was proposed more than two decades ago. The ultrasound contrast agents used for selective targeting of vascular biomarkers of disease are formulated as gas microbubbles surrounded by a thin shell.Microbubbles are decorated by the ligands that specifically bind to the biomarkers of disease overexpressed on the surface of vascular endothelium. The microbubble gas core is most often a poorly soluble perfluorinated gas (preferably CF as the least soluble), to assure circulation lifetime for at least several minutes. The gas from circulating bubbles is exhaled via the lungs; bubbles collapse and lose echogenicity. As the circulating bubbles clear from the bloodstream, adherent targeted bubbles are still retained in the tumor microvasculature and provide strong acoustic backscatter and ultrasound detection capability. A critical feature that enables ultrasound use in molecular imaging, specifically in the oncology setting, is the detection sensitivity, already enabled in medical imaging equipment. Individual microbubbles, with sub-picogram mass, can be visualized in real time, many cm deep in the body. This chapter discusses microbubble preparation and attachment of targeting ligands to the microbubble shell. The logic of the performance of ultrasound molecular imaging is discussed, followed by an assessment of a number of imaging tools.
F-Labeled Small-Molecule and Low-Molecular-Weight PET Tracers for the Noninvasive Detection of Cancer.
Waldmann CM, Kopka K, Wagner S
Recent Results Cancer Res · 2026 · PMID 42149183 · Publisher ↗
Non-invasive molecular imaging of cancer by means of the hybrid imaging modalities PET/CT and PET/MRI represents a powerful diagnostic tool in modern nuclear medicine. Radiotracers labeled with the prominent positron-emi...
Non-invasive molecular imaging of cancer by means of the hybrid imaging modalities PET/CT and PET/MRI represents a powerful diagnostic tool in modern nuclear medicine. Radiotracers labeled with the prominent positron-emitter fluorine-18 are routinely used to target and visualize distinct biological structures dysregulated in the progression of cancer. Such tracers are therefore capable of detecting oncological pathologies in vivo at the cellular and subcellular levels in a timely manner and are thereby used for early detection of cancer as well as monitoring for treatment response in a personalized manner. This chapter describes a variety of important F-labeled radiopharmaceuticals that are frequently used in oncological PET imaging. Small-molecule and low-molecular-weight radiotracers for the detection of glucose utilization, amino acid transport, membrane lipid synthesis, cell proliferation, cell death, hypoxia, estrogen receptor status, DNA repair, tumor stroma, and bone mineralization of tumors are introduced. Radiotracers targeting the prostate-specific membrane antigen (PSMA) and the somatostatin receptor subtype 2 (SSTR2) expression are introduced as diagnostic companions in the important field of oncological radionuclide theranostics.The structural properties, common radiochemical synthesis approaches, as well as in vivo metabolism and accumulation mechanisms of the clinically most important F-labeled radiotracers are described.
Single Photon Emission Computed Tomography Tracer.
Pietzsch HJ, Müller C, Schibli R … +1 more , Mamat C
Recent Results Cancer Res · 2026 · PMID 42149182 · Publisher ↗
Single-photon emission computed tomography (SPECT) is the state-of-the-art imaging modality in nuclear medicine, although only a few new SPECT tracers have become available in the past 20 years. Critical for the future s...
Single-photon emission computed tomography (SPECT) is the state-of-the-art imaging modality in nuclear medicine, although only a few new SPECT tracers have become available in the past 20 years. Critical for the future success of SPECT is the design of new and specific tracers for the detection, localization, and staging of a disease and for monitoring therapy. The utility of SPECT imaging to address oncologic questions is dependent on radiotracers that ideally exhibit excellent tissue penetration, high affinity to the tumor-associated target structure, specific uptake and retention in the malignant lesions, and rapid clearance from non-targeted tissues and organs. In general, a target-specific SPECT radiopharmaceutical can be divided into two main parts: a targeting biomolecule (e.g., small molecular compound, peptide, antibody fragment) and a γ-radiation-emitting radionuclide (e.g., Tc, I). If radiometals are used as the radiation source, a bifunctional chelator is needed to link the radionuclide to the targeting entity. In a rational SPECT tracer design, these single components have to be critically evaluated in order to achieve a balance among the demands for adequate target binding and a rapid clearance of the radiotracer. In recent years, the theranostic combination of γ-emitters with therapeutic radionuclides (α, β) was forced. The focus of this chapter is to depict recent developments of tumor-targeted SPECT radiotracers for imaging of cancer diseases. Possibilities for optimization of tracer design and potential causes for design failure are discussed and highlighted with selected examples.
Multifunctional Magnetic Resonance Imaging Probes.
Komljenovic D, Biegger P, Abeln H … +1 more , Ladd ME
Recent Results Cancer Res · 2026 · PMID 42149181 · Publisher ↗
Magnetic resonance imaging is characterized by high spatial resolution and unsurpassed soft tissue discrimination. Development and characterization of both intrinsic and extrinsic magnetic resonance (MR) imaging probes i...
Magnetic resonance imaging is characterized by high spatial resolution and unsurpassed soft tissue discrimination. Development and characterization of both intrinsic and extrinsic magnetic resonance (MR) imaging probes in the last decade has further strengthened the pivotal role MR imaging holds in the assessment of cancer in preclinical and translational settings. Sophisticated chemical modifications of a variety of nanoparticulate probes hold the potential to deliver valuable multifunctional tools applicable in diagnostics and/or treatment in human oncology. MR imaging suffers from a lack of sensitivity achievable by, e.g., nuclear medicine imaging methods. Advantages of including additional functionality/functionalities in a probe suitable for MR imaging are thus numerous, comprising the addition of fundamentally different imaging information (diagnostics), drug delivery (therapy), or the combination of both (theranostics). In recent years, we have witnessed a plethora of preclinical multimodal or multifunctional imaging probes being published, mainly as proof-of-principle studies, yet only a handful remain readily applicable in clinical settings. This chapter summarizes recent innovations in the development of multifunctional MR imaging probes and discusses the suitability of these probes for clinical transfer.
Optical and Optoacoustic Imaging.
Razansky D, Kalva SK, Gujrati V … +1 more , Ntziachristos V
Recent Results Cancer Res · 2026 · PMID 42149180 · Publisher ↗
This chapter explores how medical imaging has evolved beyond simple visual observation to include advanced optical technologies for disease detection. Traditionally, clinicians relied heavily on human vision, either dire...
This chapter explores how medical imaging has evolved beyond simple visual observation to include advanced optical technologies for disease detection. Traditionally, clinicians relied heavily on human vision, either directly or through video systems, for identifying abnormalities during examinations, surgeries, and endoscopic procedures. While high-definition white-light and stereoscopic imaging enhance these capabilities, they still fundamentally depend on what the human eye can distinguish.Optical coherence tomography (OCT) marked a significant advance by providing high-resolution images below the tissue surface, particularly benefiting ophthalmology and, more recently, cardiology. However, OCT is limited to morphological contrast and cannot capture molecular information.Thus, this chapter introduces two innovative light-based modalities. The first modality, Fluorescence Molecular Imaging (FMI), leverages targeted fluorescent agents to highlight molecular features in living tissues. Recently, FMI has moved beyond older approaches that used non-specific dyes like Indocyanine Green (ICG) to targeted dyes that enable visualization of molecular details. The second modality, optoacoustic imaging, uses light to excite ultrasound waves within tissue to generate high-resolution images at greater depths than traditional optical techniques. This modality can resolve spectral signatures of molecules or agents, providing comprehensive views of tissue structure, function, and molecular composition. Together, these advances in FMI and optoacoustic imaging promise more sensitive, specific, and non-invasive disease detection and characterization, signaling a new era in clinical imaging.
Ultrasound Imaging.
Schmitz G, Dencks S
Recent Results Cancer Res · 2026 · PMID 42149179 · Publisher ↗
Ultrasound imaging has played an important role in oncological imaging for more than five decades now. It can be applied in all tissues that are not occluded by bone or gas-filled regions. The quality of ultrasound image...
Ultrasound imaging has played an important role in oncological imaging for more than five decades now. It can be applied in all tissues that are not occluded by bone or gas-filled regions. The quality of ultrasound images benefitted strongly from improved electronics, advanced reconstruction algorithms, and increased computational power. To the morphological imaging, several functional imaging methods were added: Flow visualization became possible by Doppler techniques, and the elastic properties of tissues can be imaged by elastographic methods with transient shear wave imaging. In the beginning of molecular imaging, ultrasound with its contrast based on mechanical tissue properties was an unlikely candidate to play a role. However, with contrast agents consisting of micrometer-sized gas bubbles, which can be imaged with high sensitivity, ligands addressing targets in the vascular wall could be used. Because even single bubbles can be detected, this led to various ultrasound molecular imaging techniques and the ongoing development of clinical molecular contrast media. In this chapter, the basic properties of ultrasonic imaging, like its contrast mechanisms and spatiotemporal resolution, are discussed. The image formation and its change from line-oriented scanning to full-volume reconstructions are explained. Then, the ultrasound contrast media and imaging techniques are introduced. Finally, emerging new methods like super-resolution vascular imaging demonstrate the ongoing development in this field.
Total Body PET.
Providência L, Tsoumpas C, Lammertsma AA
Recent Results Cancer Res · 2026 · PMID 42149178 · Publisher ↗
Total body PET, or long axial field-of-view PET, is a PET scanner with an extended axial coverage compared with conventional PET scanners. The significant gain in sensitivity of these systems enables shorter scanning tim...
Total body PET, or long axial field-of-view PET, is a PET scanner with an extended axial coverage compared with conventional PET scanners. The significant gain in sensitivity of these systems enables shorter scanning times, delayed imaging or lower injected activities, making PET imaging accessible to a broader range of patient groups, including children, pregnant women, and intensive care patients. Non-invasive quantification is made possible by scanning dynamically most of the body in a single bed position, with most organs of interest within the field-of-view. Furthermore, it makes it possible to perform research in areas such as organ-axes and multi-tracer PET. This chapter provides a comprehensive overview of what this system has to offer to the field of oncology, starting from a theoretical point of view, moving on to possible clinical applications and concluding with a discussion of still underexplored areas and future possibilities.
(Hybrid) SPECT and PET Technologies.
Lemainque T, Gross-Weege N, Schulz V
Recent Results Cancer Res · 2026 · PMID 42149177 · Publisher ↗
SPECT and PET are nuclear tomographic imaging modalities that visualize functional information based on the accumulation of radioactive tracer molecules. However, SPECT and PET lack anatomical information, which has moti...
SPECT and PET are nuclear tomographic imaging modalities that visualize functional information based on the accumulation of radioactive tracer molecules. However, SPECT and PET lack anatomical information, which has motivated their combination with an anatomical imaging modality such as CT or MRI. This chapter begins with an overview of the fundamental physics of SPECT and PET, followed by a presentation of the respective detector technologies, including detection requirements, principles, and different detector concepts. The reader is subsequently provided with an introduction to hybrid imaging concepts, before a dedicated section presents the challenges that arise when hybridizing SPECT or PET with MRI, namely, mutual distortions of the different electromagnetic fields in MRI on the nuclear imaging system and vice versa, and MR-based attenuation correction. The chapter then gives an overview about current hybrid imaging systems of both clinical and preclinical kinds and recent technological developments such as total body PET-CT, before describing the role of artificial intelligence in hybrid imaging. Finally, future developments in hybrid SPECT and PET technology are discussed.
Computed Tomography and Magnetic Resonance Imaging.
McLaughlin M, van Straten M, Warnert EAH … +6 more , Verhoeven M, van Tiel ST, Essers J, Strijkers GJ, Coolen BF, Bernsen MR
Recent Results Cancer Res · 2026 · PMID 42149176 · Publisher ↗
Imaging in Oncology is rapidly moving from the detection and size measurement of a lesion to the quantitative assessment of metabolic processes and cellular and molecular interactions. Increasing insights into cancer as...
Imaging in Oncology is rapidly moving from the detection and size measurement of a lesion to the quantitative assessment of metabolic processes and cellular and molecular interactions. Increasing insights into cancer as a complex disease with involvement of the tumor stroma in tumor pathobiological processes have made it clear that for successful control of cancer, treatment strategies should not only be directed at the cancer cells but should also take aspects of the tumor microenvironment into account. This requires an understanding of the complex molecular and cellular interactions in cancer tissue. Recent developments in imaging technology have increased the possibility of imaging various pathobiological processes in cancer development and response to treatment. For computed tomography (CT) and magnetic resonance imaging (MRI), various improvements in hardware, software, and imaging probes have lifted these modalities from classical anatomical imaging techniques to techniques suitable for imaging and quantifying various physiological processes and molecular and cellular interactions. Next to a more general overview of possible imaging targets in oncology, this chapter provides an overview of the various developments in CT and MRI technology and some specific applications.
Advanced X-Ray Imaging Technology.
Pfeiffer D, Rummeny E, Pfeiffer F
Recent Results Cancer Res · 2026 · PMID 42149175 · Publisher ↗
Since their discovery by Wilhelm Conrad Röntgen in 1895, X-rays have become the most widely available, typically fastest, and usually most cost-effective medical imaging modality today. From the early radiographic approa...
Since their discovery by Wilhelm Conrad Röntgen in 1895, X-rays have become the most widely available, typically fastest, and usually most cost-effective medical imaging modality today. From the early radiographic approaches using X-ray films as detectors, the portfolio of medical X-ray imaging devices developed into a large range of dedicated instrumentation for various applications. While X-ray imaging has come a long way, there are some physical properties of X-rays that have not yet been fully exploited, and which may offer quite some room for further enhancements of current X-ray imaging equipment. Firstly, X-ray imaging today is mainly black and white, despite the fact that X-ray generators actually create a full spectrum of X-ray energies, and that the interactions of X-rays that occur within the human body are not the same for all energies and every material. Exploiting these spectral dependencies allows to not only obtain a black and white CT image, but also to obtain more molecularly specific information, which is relevant particularly in oncological precision radiology. The second aspect of X-rays, and so far in radiology mainly neglected and unused, is the physical fact that X-rays can also be interpreted in the wave picture, and not only as presently done in the particle picture. If interpreted as waves, X-rays-just like visible light-experience a phase shift in matter, and this-if exploited correctly-can produce a new class of X-ray images, which then depict the wave interactions of X-rays with matter, rather than only the attenuating properties, as done until now.
Systemic Therapies for Advanced Medullary Thyroid Carcinoma.
Santillan MR, Dadu R, Gagel RF … +2 more , Grubbs EG, Hu MI
Recent Results Cancer Res · 2025 · PMID 40102263 · Publisher ↗
Medullary thyroid carcinoma (MTC) is a rare disease that is indolent in the majority of patients. In a subset of patients, the cancer is more aggressive with symptomatic or progressive disease metastasizing to cervical n...
Medullary thyroid carcinoma (MTC) is a rare disease that is indolent in the majority of patients. In a subset of patients, the cancer is more aggressive with symptomatic or progressive disease metastasizing to cervical neck structures, lungs, liver, and/or bones. Definitive cure for metastatic MTC remains elusive. Understanding oncogenic pathways and molecular drivers of disease have led to development and approval of multikinase and highly-specific RET inhibitors for the management of progressive MTC. RET mutations are the most common drivers in MTC, followed by mutually exclusive RAS mutations. Cabozantinib and vandetanib, multikinase inhibitors (MKIs) that exert their therapeutic effect mainly through antiangiogenesis by targeting the vascular endothelial growth factor receptor, have mild anti-RET activity. Despite conveying clinical responses in MTC, MKIs have significant off-target activity causing marked toxicities limiting their effectiveness. Potent and selective RET inhibitors, selpercatinib and pralsetinib, demonstrate significant efficacy in RET-altered cancers and more tolerable side effect profiles than MKIs. However, durable responses can be limited by the acquisition of mutations which confer drug resistance to available treatments. Thus, development of more effective treatments for advanced, progressive MTC remains an urgent priority. In this chapter, we describe the current spectrum of systemic therapies for MTC, their limitations, and ongoing investigations.
Long-Term Follow-Up in Medullary Thyroid Carcinoma Patients.
Raue F, Frank-Raue K
Recent Results Cancer Res · 2025 · PMID 40102262 · Publisher ↗
After surgery, patients with MTC (medullary thyroid carcinoma) should be assessed for the presence of residual disease, the localization of metastases, and the identification of progressive disease. Postoperative staging...
After surgery, patients with MTC (medullary thyroid carcinoma) should be assessed for the presence of residual disease, the localization of metastases, and the identification of progressive disease. Postoperative staging is used to separate low-risk patients from high-risk patients with MTC. In addition to the TNM system, further histological staging with Ki67, mitotic count, tumor necrosis, and molecular analysis of somatic RET mutations is helpful for the stratification of patients in different prognostic categories. The number of lymph node metastases and involved compartments as well as postoperative Ctn (calcitonin) and CEA (carcinoembryonic antigen) levels should also be documented. Postoperative nonmeasurable Ctn levels are associated with a favorable outcome. In patients with basal serum Ctn levels less than 150 pg/ml following thyroidectomy, persistent or recurrent disease is almost always confined to lymph nodes in the neck. If the postoperative serum Ctn level exceeds 150 pg/ml, patients should be evaluated by imaging procedures, including neck and chest CT (computed tomography), contrast-enhanced MRI, US of the liver, bone scintigraphy, MRI of the bone and positron emission tomography (PET)/CT. One can estimate the growth rate of MTC metastases from sequential imaging studies using response evaluation criteria in solid tumors (RECIST) that document increases in tumor size over time and by measuring serum levels of Ctn or CEA over multiple time points to determine the tumor marker doubling time. One of the main challenges remains finding effective adjuvant and palliative options for patients with metastatic disease. Patients with persistent or recurrent MTC localized to the neck and slightly elevated Ctn levels following thyroidectomy might be candidates for neck reoperations depending on the extent of the tumor. Once metastases appear, the clinician must decide which patients require therapy, balancing the frequently slow rate of tumor progression associated with a good quality of life and suggesting active surveillance against the limited efficacy and potential toxicities of local and systemic therapies. Considering that metastatic MTC is incurable, the management goals are to provide locoregional disease control, palliate symptoms such as diarrhea, palliate symptomatic metastases causing pain or bone fractures, and control metastases that threaten life through bronchial obstruction or spinal cord compression. This can be achieved by palliative surgery, EBRT (external beam radiation therapy) or systemic therapy using multikinase inhibitors (MKIs) targeting RET or selective RET inhibitors requiring genetic testing prior to the initiation of therapy.
Surgical Treatment of Medullary Thyroid Cancer.
Machens A, Dralle H
Recent Results Cancer Res · 2025 · PMID 40102261 · Publisher ↗
Medullary thyroid cancer (MTC) is an infrequent calcitonin-secreting thyroid malignancy that can vary a great deal in tumor biology and progression. The most important determinant of distant metastases, which represents...
Medullary thyroid cancer (MTC) is an infrequent calcitonin-secreting thyroid malignancy that can vary a great deal in tumor biology and progression. The most important determinant of distant metastases, which represents the single greatest risk factor of poor cancer-specific survival, is lymph node metastasis in the neck and mediastinum. In patients with node-positive MTC, systematic compartment-oriented dissection of central and lateral neck nodes at the initial operation promotes biochemical cure and decreases the risk of locoregional recurrence in previously dissected lymph node compartments. Routine calcitonin screening in nodular thyroid disease and genomic screening, flanked by advances in ultrasound and functional imaging modalities, have been pivotal in making the diagnosis early and enabling risk-reducing surgical interventions in patients with sporadic and hereditary MTC, without compromising clinical outcome. To assess a RET carrier's risk of medullary thyroid cancer, all that is needed is patient age, underlying RET mutation, and biomarker levels. Recently, risk-reducing surgery, consisting in hemithyroidectomy with or without diagnostic ipsilateral central lymph node dissection, has been advocated for sporadic MTC clinically confined to one thyroid lobe that is desmoplasia negative on intraoperative frozen sectioning. These recent developments reflect the current shift from reactive to increasingly preemptive, risk-reducing surgery for MTC.
Primary Hyperparathyroidism in MEN2 Syndromes.
Saltiki K, Alevizaki M
Recent Results Cancer Res · 2025 · PMID 40102260 · Publisher ↗
One of the components of the classical form of MEN2 syndromes is primary hyperparathyroidism (PHP). It occurs in 20-30% of the typical MEN2A syndrome. Recently, the prevalence in ret gene carriers is rarer possibly due t...
One of the components of the classical form of MEN2 syndromes is primary hyperparathyroidism (PHP). It occurs in 20-30% of the typical MEN2A syndrome. Recently, the prevalence in ret gene carriers is rarer possibly due to the increased recognition of cases who have familial MTC only. PHP is diagnosed more frequently in association with the exon 11, 634 mutation of the ret gene-so there is phenotype/genotype correlation. The clinical manifestations of PHP in MEN2 are usually mild and the peak age of diagnosis is after the third decade. The treatment is surgical excision of the enlarged gland(s). Although there can be multigland disease in the parathyroids, it is frequently the case that both hyperplasia and adenoma may coexist, or even a single adenoma may be found during the investigation and finally during the operation. Patients with MEN2 syndromes should be screened for PHP with serum calcium measurements. The intensity of the screening should be higher in those carrying the ret mutations most frequently associated with this manifestation.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe