Advances in Functional Imaging of Differentiated Thyroid Cancer

Simple Summary Since the 1940s, radioactive iodine has been used for functional imaging and for treating patients with differentiated thyroid cancer (DTC). During this long-lasting experience, the use of iodine isotopes evolved, especially during the last years due to improved knowledge of thyroid cancer biology and improved performances of imaging tools. The present review summarizes recent advances in the field of functional imaging and theragnostic approach of DTC. The present review provides a description of recent advances in the field of functional imaging that takes advantage of the functional characteristics of thyroid neoplastic cells (such as radioiodine uptake and FDG uptake) and theragnostic approach of differentiated thyroid cancer (DTC). Physical and biological characteristics of available radiopharmaceuticals and their use with state-of-the-art technologies for diagnosis, treatment, and follow-up of DTC patients are depicted. Radioactive iodine is used mostly with a therapeutic intent, while PET/CT with F-18-FDG emerges as a useful tool in the diagnostic management and complements the use of radioactive iodine. Beyond F-18-FDG PET/CT, other tracers including I-124, F-18-TFB and Ga-68-PSMA, and new methods such as PET/MR, might offer new opportunities in selecting patients with DTC for specific imaging modalities or treatments.