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F-18 FDG PET/CT in the management of thyroid cancer
- Source :
- Clinical nuclear medicine. 32(9)
- Publication Year :
- 2007
-
Abstract
- Purpose There are approximately 32,000 new cases of thyroid carcinoma annually in the United States. F-18 FDG PET/CT has an established role in cancer management, including thyroid cancer, usually in patients who are thyroglobulin (Tg) positive/iodine negative. We reviewed our experience with F-18 FDG PET/CT in thyroid cancer, with an emphasis on correlation with Tg, and maximum standardized uptake values (SUV). We also analyzed the role of thyroid stimulating hormone (TSH) on PET/CT results. Materials and methods This is a retrospective study (January 2003 to December 2006) of 76 patients with differentiated thyroid cancer, who had F-18 FDG PET/CT scans. There were 44 women and 32 men, with age range of 20 to 81 years (average, 51.1 +/- 18.1). The administered doses of F-18 FDG ranged from 396 to 717 MBq (15.8-19.4 mCi) (average, 566 +/- 74.8) (15.3 +/- 2). Reinterpretation of the imaging studies for accuracy and data analysis from medical records were performed. Results A total of 98 PET/CT scans were analyzed (59 patients had 1 scan, 12 patients had 2, and 5 patients had 3). PET/CT was 88.6% sensitive (95% CI: 78.-94.3) and 89.3% specific (95% CI: 71.9-97.1). Mean Tg level was 1203 ng/mL (range, 0.5-28,357) in patients with positive PET/CT and 9.72 ng/mL (range, 0.5-123.0) in patients with negative PET/CT scans (P = 0.0389). Mean SUV max was 10.8 (range, 2.5-32) in the thyroid bed recurrence/residual disease and 7.53 (range, 2.5-26.2) in metastatic lesions (P = 0.0114). Mean SUV max in recurrent/residual disease in patients with TSH 30 mIU/L was 8.1 (range, 2.6-32) (P = 0.2994). Conclusion F-18 FDG PET/CT had excellent sensitivity (88.6%) and specificity (89.3%) in this patient population. Metastatic lesions were reliably identified, but were less F-18 FDG avid than recurrence/residual disease in the thyroid bed. TSH levels at the time of PET/CT did not appear to impact the FDG uptake in the lesions or the ability to detect disease. In the setting of high or rising levels of Tg, our study confirms that it is indicated to include PET/CT in the management of patients with differentiated thyroid cancer.
- Subjects :
- Adult
Male
medicine.medical_treatment
chemistry.chemical_element
Thyrotropin
Iodine
Sensitivity and Specificity
Thyroglobulin
Thyroid carcinoma
Thyroid-stimulating hormone
Fluorodeoxyglucose F18
Medicine
Humans
Radiology, Nuclear Medicine and imaging
Thyroid Neoplasms
Thyroid cancer
Aged
Retrospective Studies
Aged, 80 and over
business.industry
Thyroid
Reproducibility of Results
Retrospective cohort study
General Medicine
Middle Aged
medicine.disease
Image Enhancement
F 18 fdg pet ct
medicine.anatomical_structure
chemistry
Positron-Emission Tomography
Subtraction Technique
Female
Radiopharmaceuticals
business
Nuclear medicine
Tomography, X-Ray Computed
Subjects
Details
- ISSN :
- 03639762
- Volume :
- 32
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Clinical nuclear medicine
- Accession number :
- edsair.doi.dedup.....4f756a886eab9b8dd38b7d3b500c132c