{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T22:47:14Z","timestamp":1761518834703},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2007,1,3]],"date-time":"2007-01-03T00:00:00Z","timestamp":1167782400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2007,3]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p><jats:bold>Background\u2002<\/jats:bold> High calcitonin (CT) serum levels suggest metastatic spread in medullary thyroid carcinoma (MTC) after thyroidectomy. In limited disease stages, however, morphological investigations including ultrasound, magnetic resonance imaging (MRI) and 18F\u2010FDG positron emission tomography ([18F]FDG\u2010PET) may often fail to identify exact tumour sites.<\/jats:p><jats:p><jats:bold>Objective\u2002<\/jats:bold> The aim of the present study was to establish an improved strategy to identify small cervical tumours by combining pentagastrin stimulation with bilateral cervical intravenous CT sampling followed by high\u2010resolution ultrasound.<\/jats:p><jats:p><jats:bold>Design and patients\u2002<\/jats:bold> Six MTC patients were examined, of whom five patients already had bilateral neck dissection. Five patients had sporadic MTC, and one patient suffered from MEN2a.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> Retrospective analysis of all patients revealed a highly sensitive positive correlation between an early calcitonin peak (20\u201340\u00a0s after pentagastrin injection) and site of cervical tumour affection. Postinterventional ultrasound examination of the affected regions of the neck revealed suspicious presence; in some cases small lymph nodes of less than 1\u00a0cm in size were then surgically excised. On histology, small tumours could be identified in four patients. Postsurgical examination revealed a clear decline of basal serum calcitonin levels in four patients (between \u221241% and \u2212100%). In two patients CT normalized to baseline levels (&lt;\u00a010\u00a0pg\/ml) and in another two patients CT rendered to near normal (14 and 17\u00a0pg\/ml).<\/jats:p><jats:p><jats:bold>Conclusion\u2002<\/jats:bold> Pentagastrin stimulation\u2010based intravenous catheter sampling may be beneficial in the diagnostic work\u2010up of MTC after thyroidectomy. Our data show that an early calcitonin peak (20\u201340\u00a0s after administration of pentagastrin) helps to identify tumour\u2010affected regions.<\/jats:p>","DOI":"10.1111\/j.1365-2265.2007.02747.x","type":"journal-article","created":{"date-parts":[[2007,1,4]],"date-time":"2007-01-04T15:11:15Z","timestamp":1167923475000},"page":"405-409","source":"Crossref","is-referenced-by-count":10,"title":["Identification of occult metastases of medullary thyroid carcinoma by pentagastrin\u2010stimulated intravenous calcitonin sampling followed by targeted surgery"],"prefix":"10.1111","volume":"66","author":[{"given":"Matthias","family":"Schott","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Holger 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