Can 18F-FDG-PET/CT be generally recommended in patients with differentiated thyroid carcinoma and elevated thyroglobulin levels but negative I-131 whole body ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2012-01

AUTHORS

Peter Bannas, Thorsten Derlin, Michael Groth, Ivayla Apostolova, Gerhard Adam, Janos Mester, Susanne Klutmann

ABSTRACT

BACKGROUND: Exact localization of recurrent iodine-negative thyroid cancer is mandatory, since surgery is the only curative therapy option in patients with iodine-negative tumor tissue. The aim of this study was to evaluate the impact of (18)F-FDG-PET/CT as a routine diagnostic tool on clinical management in patients with suspected thyroid cancer recurrence and elevated serum thyroglobulin (Tg) but negative radioiodine whole body scan. METHODS AND MATERIALS: After total thyroidectomy followed by radioiodine ablation, 30 consecutive patients with differentiated thyroid cancer, elevated serum thyroglobulin levels and negative whole body radioiodine scan underwent (18)F-FDG-PET/CT. Results were verified by histology, ultrasound, or clinical follow-up. Diagnostic accuracy was determined for the whole study population and for subgroups with serum thyroglobulin below and above 10 ng/ml, respectively. Impact of PET/CT on clinical management was assessed. RESULTS: PET/CT identified FDG accumulating lesions in 19 of 30 patients. 17 were true-positive and 2 false-positive. In the true-positive group, 11 of the 17 patients had loco-regional disease, 3 had distant metastases only and 3 patients had both loco-regional and distant metastatic involvement. (18)F-FDG-PET/CT was true-negative in 3 patients and false-negative in 8 patients. Overall sensitivity, specificity and accuracy were 68.0, 60.0, and 66.7%, respectively. In the subgroup of patients with serum thyroglobulin above 10 ng/ml (n = 21) the sensitivity, specificity and accuracy were substantially higher with 70.0, 100.0, and 71.4%, respectively. Clinical management was changed for 17 (57%) of 30 patients, guiding to a curative surgical intervention in 9 patients (30%). CONCLUSIONS: (18)F-FDG-PET/CT enables detection and precise localization of loco-regional recurrence and distant metastases of differentiated thyroid cancer in patients with elevated serum thyroglobulin but negative radioiodine with significant impact on patient management and can therefore be recommended as a routine diagnostic tool. More... »

PAGES

77-85

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12149-011-0545-4

DOI

http://dx.doi.org/10.1007/s12149-011-0545-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1033206447

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/22006540


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