Abstract

BackgroundThe prevalence of thyroid nodules increases with age, average 4–7% for the U.S.A. adult population, but it is much higher (19–67%) when sub-clinical nodules are considered. About 90% of these lesions are benign and a reliable approach to their preoperative characterization is necessary. Unfortunately conventional thyroid scintigraphy does not allow the distinction among benign and malignant thyroid proliferations but it provides only functional information (cold or hot nodules).The expression of the anti-apoptotic molecule galectin-3 is restricted to cancer cells and this feature has potential diagnostic and therapeutic implications. We show here the possibility to obtain thyroid cancer imaging in vivo by targeting galectin-3.MethodsThe galectin-3 based thyroid immuno-scintigraphy uses as radiotracer a specific 99mTc-radiolabeled mAb. A position-sensitive high-resolution mini-gamma camera was used as imaging capture device. Human galectin-3 positive thyroid cancer xenografts (ARO) and galectin-3 knockout tumors were used as targets in different experiments in vivo. 38 mice with tumor mass of about 1 gm were injected in the tail vein with 100 µCi of 99mTc-labeled mAb to galectin-3 (30 µg protein/in 100 µl saline solution). Tumor images were acquired at 1 hr, 3 hrs, 6 hrs, 9 hrs and 24 hrs post injection by using the mini-gamma camera.FindingsResults from different consecutive experiments show an optimal visualization of thyroid cancer xenografts between 6 and 9 hours from injection of the radiotracer. Galectin-3 negative tumors were not detected at all. At 6 hrs post-injection galectin-3 expressing tumors were correctly visualized, while the whole-body activity had essentially cleared.ConclusionsThese results demonstrate the possibility to distinguish preoperatively benign from malignant thyroid nodules by using a specific galectin-3 radio-immunotargeting. In vivo imaging of thyroid cancer may allow a better selection of patients referred to surgery. The possibility to apply this method for imaging and treatment of other galectin-3 expressing tumors is also discussed.

Highlights

  • The high prevalence of benign thyroid nodules in adult population makes the preoperative detection of thyroid cancer comparable to ‘looking for a needle in a haystack’

  • These results demonstrate the possibility to distinguish preoperatively benign from malignant thyroid nodules by using a specific galectin-3 radio-immunotargeting

  • In vivo imaging of thyroid cancer may allow a better selection of patients referred to surgery

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Summary

Introduction

The high prevalence of benign thyroid nodules in adult population makes the preoperative detection of thyroid cancer comparable to ‘looking for a needle in a haystack’. NIS-mediated iodide uptake is required for the subsequent organification and oxidation steps, which are key events for the production of thyroid hormones. This peculiar property of the gland supports conventional thyroid scintigraphy, which uses radioiodine in defining the thyroid gland in both physiological and pathological states [4]. This widely used technique does not allow the distinction among benign and malignant thyroid proliferations. Conventional thyroid scintigraphy does not allow the distinction among benign and malignant thyroid proliferations but it provides only functional information (cold or hot nodules). We show here the possibility to obtain thyroid cancer imaging in vivo by targeting galectin-3

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