| Clinical and pathological factors related to 18F-FDG-PET positivity in the diagnosis of recurrence and/or metastasis in patients with differentiated thyroid cancer. | |
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MedLine Citation:
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PMID: 19415387 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Objectives were to analyze the relationship between a positive (18)F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) result and clinical and tumor factors in patients treated for differentiated thyroid cancer (DTC) and under suspicion of recurrence or metastasis, and to determine the diagnostic validity of PET in DTC patients with elevated serum thyroglobulin (Tg) and negative (131)I whole-body scan ((131)I-WBS). METHODS: We studied 50 DTC patients with elevated serum Tg and negative WBS treated with total thyroidectomy and (131)I ablation. Thyroxin treatment was withdrawn and patients were on iodine-free diet before WBS. Tg, anti-Tg antibodies, and thyroid-stimulating hormone (TSH) were determined. Patients with negative WBS and elevated Tg underwent PET study 1 week later. PET findings were verified by pathology findings or other imaging techniques [computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US)] and/or 12-month follow-up. The relationship between PET findings and tumor (histological type, size, multifocality, thyroid capsular invasion, lymph-node and/or metastatic involvement) and clinical (age at diagnosis, sex, Tg, accumulated iodine dose, and recurrence time) variables was analyzed. RESULTS: PET was positive in 32/39 patients with confirmed disease (82% sensitivity) and negative in 7/11 of disease-free cases (64% specificity), a positive predictive value (PPV) of 89%. Tumor size (P < 0.05) and thyroid capsular invasion (P < 0.05) were significantly associated with positive PET study. The relationship of PET findings with Tg levels and age at diagnosis was close to significance. CONCLUSION: (18)F-FDG-PET study offers a high sensitivity and positive predictive value (PPV) in patients with negative WBS and Tg positive. The use of FDG-PET is strongly recommended in DTC patients with large tumors, thyroid capsule invasion or poor-prognosis variants. |
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Authors:
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D Esteva; M A Muros; J M Llamas-Elvira; J Jiménez Alonso; J M Villar; M López de la Torre; T Muros |
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Publication Detail:
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Type: Journal Article Date: 2009-05-05 |
Journal Detail:
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Title: Annals of surgical oncology Volume: 16 ISSN: 1534-4681 ISO Abbreviation: Ann. Surg. Oncol. Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-06-15 Completed Date: 2009-08-19 Revised Date: 2011-01-26 |
Medline Journal Info:
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Nlm Unique ID: 9420840 Medline TA: Ann Surg Oncol Country: United States |
Other Details:
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Languages: eng Pagination: 2006-13 Citation Subset: IM |
Affiliation:
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Internal Medicine Department, Virgen de las Nieves University Hospital, Granada, Spain. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Child Female Fluorodeoxyglucose F18 / diagnostic use Humans Male Middle Aged Neoplasm Recurrence, Local / radionuclide imaging* Positron-Emission Tomography* Radiopharmaceuticals / diagnostic use Sensitivity and Specificity Thyroglobulin / blood Thyroid Neoplasms / radionuclide imaging*, secondary Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18; 9010-34-8/Thyroglobulin |
| Comments/Corrections | |
Comment In:
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Ann Surg Oncol. 2011 Jan;18(1):291
[PMID:
20505997
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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