Positron emission tomography tracers in medullary thyroid carcinoma: Current evidence and emerging targets

doi:10.4329/wjr.v18.i5.120146

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World Journal of Radiology

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1949-8470

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Radiol. May 28, 2026; 18(5): 120146
Published online May 28, 2026. doi: 10.4329/wjr.v18.i5.120146

Positron emission tomography tracers in medullary thyroid carcinoma: Current evidence and emerging targets

Fahad W Ahmed, Fauwad Ahmed

Fahad W Ahmed, Department of Medicine, King Faisal Specialist Hospital and Research Centre, Madinah 42522, Saudi Arabia

Fauwad Ahmed, St Michael Pain and Spine Clinics, Houston, TX 77054, United States

Author contributions: Ahmed FW conceptualised the review, conducted the literature search, and drafted the manuscript; Ahmed F contributed to data synthesis and critical revision of the manuscript; and all authors prepared the draft and approved the final version.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Corresponding author: Fahad W Ahmed, PhD, FRCP, Consultant, Department of Medicine, King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Madinah 42522, Saudi Arabia. fahadwali@yahoo.com

Received: February 24, 2026
Revised: March 5, 2026
Accepted: April 1, 2026
Published online: May 28, 2026
Processing time: 99 Days and 6.2 Hours

Core Tip

Core Tip: Selecting the right positron emission tomography tracer in medullary thyroid carcinoma depends on tumour biology. This article synthesizes evidence from five databases indicating that fluorodihydroxyphenylalanine remains the most sensitive tracer for recurrent disease, whereas fluorodeoxyglucose better captures aggressive, dedifferentiated tumours. Somatostatin receptor imaging, though less sensitive overall, is indispensable for identifying candidates for peptide receptor radionuclide therapy. We propose an expert-informed, biology-guided algorithm linking biomarker kinetics to tracer choice and highlight cholecystokinin-2 receptor and fibroblast activation protein as promising emerging targets.