FDG PET/CT ability to detect medullary thyroid cancer (MTC) lesions is related to the increased glycolysis inherent to the tumour cells. Increased FDG avidity correlates with a higher proliferation rate and poorer differentiation.

The detection rate of FDG PET/CT in patients with medullary thyroid cancer (MTC) significantly improves in patients with higher serum Calcitonin and carcinoembryonic antigen (CEA) levels.

Other PET radiotracers used for imaging of MTC include F18-FDOPA and somatostatin analogues such as Ga68-DOTATATE.

FDOPA shows increased uptake and storage in MTC and other neuroendocrine tumour (NETs) via upregulated amino acid transporter systems and increased enzymatic conversion of DOPA to dopamine.

Somatostatin analogues detect MTC via the overexpression of somatostatin receptors on the cell surface of NETs.