Document Detail


Clinical usefulness of positron emission tomography-computed tomography in recurrent thyroid carcinoma.
MedLine Citation:
PMID:  20157055     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine the efficacy of combined positron emission tomography-computed tomography (PET-CT) in identifying recurrent thyroid cancer and to elucidate its role in the clinical management of thyroid carcinoma. DESIGN: Retrospective study. SETTING: Tertiary care referral academic center. PATIENTS: One hundred twenty-four patients with previously treated thyroid carcinoma who underwent PET-CT. MAIN OUTCOME MEASURES: PET-CT images were correlated with clinicopathologic information. The influence of PET-CT findings on disease status determination and the treatment plan was evaluated. RESULTS: Among 121 patients undergoing iodine I 131 ((131)I) imaging (an (131)I image was unavailable for 3 patients), 80.6% had negative findings on (131)I imaging before undergoing PET-CT. Among 75 patients who had positive findings on PET-CT, 71 were true positive results. Among 49 patients who had negative findings on PET-CT, 32 were true negative results. Therefore, PET-CT demonstrated a sensitivity of 80.7%, specificity of 88.9%, positive predictive value of 94.7%, and negative predictive value of 65.3%. A significant difference was noted in the mean serum thyroglobulin levels between patients with positive vs negative PET-CT findings (192.1 vs 15.0 ng/mL, P = .01) (to convert thyroglobulin level to micrograms per liter, multiply by 1.0). Overall, distant metastases were detected in 20.2% of patients using PET-CT. There was an alteration of the treatment plan in 28.2% of patients as a result of added PET-CT information, and 21.0% of patients underwent additional surgery. CONCLUSIONS: PET-CT is usually performed in patients with thyroid cancer having elevated thyroglobulin levels but non-(131)I-avid tumors and has high diagnostic accuracy for identifying local, regional, and distant metastases. Additional information from PET-CT in patients with (131)I-negative and thyroglobulin-positive tumors frequently guides the clinical management of recurrent thyroid carcinoma.
Authors:
Ali Razfar; Barton F Branstetter; Apostolos Christopoulos; Shane O Lebeau; Steven P Hodak; Dwight E Heron; Edward J Escott; Robert L Ferris
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of otolaryngology--head & neck surgery     Volume:  136     ISSN:  1538-361X     ISO Abbreviation:  Arch. Otolaryngol. Head Neck Surg.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-16     Completed Date:  2010-03-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8603209     Medline TA:  Arch Otolaryngol Head Neck Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  120-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Otolaryngology, University of Pittsburgh, PA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma, Follicular / blood,  diagnosis
Adenocarcinoma, Papillary / blood,  diagnosis
Adenoma, Oxyphilic / blood,  diagnosis
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Female
Humans
Male
Middle Aged
Neoplasm Recurrence, Local / blood,  diagnosis*
Positron-Emission Tomography*
Predictive Value of Tests
Retrospective Studies
Thyroglobulin / blood
Thyroid Neoplasms / blood,  diagnosis*,  secondary
Tomography, X-Ray Computed*
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
9010-34-8/Thyroglobulin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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