The Evolving Role of Somatostatin Receptor PET/CT in Medullary Thyroid Carcinoma: An Updated Systematic Review and Meta-Analysis

Background/Objectives: Medullary thyroid carcinoma (MTC) is a neuroendocrine tumor that often expresses somatostatin receptors (SSTRs). While various PET radiopharmaceuticals were used, there is no universal consensus on the optimal imaging modality for whole-body assessment of MTC. This study aims to evaluate the detection rate (DR) and clinical management impact of SSTR PET/CT imaging in patients with MTC. Methods: A systematic search was conducted across PubMed/MEDLINE, Scopus, and Embase. A total of 14 studies (comprising 350 patients) were eligible for quantitative meta-analysis. Pooled DRs were calculated using a random-effects model, and methodological quality was assessed via the QUADAS-2 tool. Results: Our analysis revealed an overall DR of 75.1% (95% CI: 67.6–82.6%) for recurrent or metastatic MTC, showing moderate significant heterogeneity (I2 = 65.41%). Clinical impact of SSTR PET/CT was demonstrated in 16.6–100% of cases, primarily by identifying candidates for Peptide Receptor Radionuclide Therapy. Only a few studied investigated the relationship between serum calcitonin levels and the detection rate of SSTR PET/CT, finding a significant correlation. Conclusions: The DR of SSTR PET/CT in recurrent/metastatic MTC was high. SSTR PET/CT may have a positive impact on clinical management in a significant number of cases.