The overwhelming majority of Hurthle cell carcinoma is not iodine avid, so I-131 is ineffective in treating or diagnosing metastatic disease. Prognosis depends mainly on extent of disease at initial diagnosis and the adequacy of surgical intervention. There is no effective treatment for metastatic disease. Normal thyroid tissue also expresses somatostatin receptors. However, the concentration of somatostatin receptors is higher in Hurthle cell tumors.
False positives can result with excessive uptake of tracer in benign thyroid disease.
The main role of octreotide scintigraphy in the management of Hurthle cell carcinoma is to assess for metastatic disease. Possibly in the future somatostatin receptor analogs can be used to direct radiotherapy to treat metastatic disease, similar to I-131 treatment of metastatic thyroid follicular and papillary cancer. Follicular and Hurthle cell carcinoma of the thyroid. Endocrinol Metab Clin North Am. Carcangiu ML, Bianchi S, Savino D, Voynick IM, Rosai J. Follicular Hurthle cell tumors of the thyroid gland.