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World J Radiol. May 28, 2026; 18(5): 120146
Published online May 28, 2026. doi: 10.4329/wjr.v18.i5.120146
Figure 1
Figure 1 The “flip-flop” phenomenon in medullary thyroid carcinoma imaging. As tumours dedifferentiate along the spectrum from well-differentiated (left) to poorly-differentiated (right), 18F-fluorodihydroxyphenylalanine uptake (blue curve) progressively decreases while 18F-fluorodeoxyglucose uptake (orange curve) reciprocally increases. The crossover point represents the transition where fluorodeoxyglucose becomes more informative than fluorodihydroxyphenylalanine. MTC: Medullary thyroid carcinoma; PET: Positron emission tomography; 18F-FDOPA: 18F-fluorodihydroxyphenylalanine; 18F-FDG: 18F-fluorodeoxyglucose; AADC: Aromatic L-amino acid decarboxylase; NE: Neuroendocrine.


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