| Increasing the yield of recombinant thyroid-stimulating hormone-stimulated 2-(18-fluoride)-flu-2-deoxy-D-glucose positron emission tomography-CT in patients with differentiated thyroid carcinoma. | |
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MedLine Citation:
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PMID: 22972977 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The aim of this study was to assess the accuracy of recombinant thyroid-stimulating hormone (rTSH)-stimulated 2-(18-fluoride)-flu-2-deoxy-D-glucose ((18)F-FDG) positron emission tomography (PET)-CT in detecting recurrence in patients with differentiated thyroid cancer. METHODS: Consecutive (18)F-FDG PET-CT scans performed with rTSH stimulation between 2007 and 2010 in patients with a history of papillary or follicular thyroid carcinoma were reviewed. PET-CT findings were correlated with thyroglobulin levels, and histological, clinical and radiological follow-up. RESULTS: 58 rTSH PET-CT scans were performed in 47 patients with a previous thyroidectomy and radioiodine ablation. The only indication for PET-CT was a raised thyroglobulin level in 46 of 58 scans, with the remainder for characterisation of equivocal radiology or staging. 25 (43%) of PET-CT scans were positive for recurrent disease. Histological correlation was available for 21 (36%) scans. The overall sensitivity, specificity, positive predictive value and negative predictive value were 69%, 76%, 72% and 73%, respectively. Median unstimulated thyroglobulin in true-positive scans was 33 µg l(-1) and 2.2 µg l(-1) in the remainder (p=0.12). 4 of 35 (11%) patients with unstimulated thyroglobulin levels <10 µg l(-1) had true-positive scans. Median stimulated thyroglobulin in true-positive scans was 320 µg l(-1), and 10 µg l(-1) in the remainder (p=0.046), with no positive scans with a stimulated thyroglobulin <8 µg l(-1). PET-CT directly influenced patient management in 17/58 (29%) scans. CONCLUSION: rTSH PET-CT is a useful imaging technique for detecting disease recurrence in patients with iodine-resistant differentiated thyroid cancer. Low stimulated thyroglobulin levels are potentially useful in identifying patients unlikely to benefit from a PET-CT scan. |
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Authors:
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R J D Prestwich; S Viner; G Gerrard; C N Patel; A F Scarsbrook |
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Publication Detail:
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Type: Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The British journal of radiology Volume: 85 ISSN: 1748-880X ISO Abbreviation: Br J Radiol Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-09-13 Completed Date: 2012-11-19 Revised Date: 2013-04-16 |
Medline Journal Info:
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Nlm Unique ID: 0373125 Medline TA: Br J Radiol Country: England |
Other Details:
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Languages: eng Pagination: e805-13 Citation Subset: AIM; IM |
Affiliation:
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Department of Nuclear Medicine, St James's Institute of Oncology, Leeds, UK. robin.prestwich@leedsth.nhs.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenocarcinoma, Follicular
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blood,
radionuclide imaging Adolescent Adult Aged Aged, 80 and over Carcinoma / blood, radionuclide imaging Female Fluorodeoxyglucose F18 / diagnostic use* Humans Male Middle Aged Neoplasm Recurrence, Local / radionuclide imaging* Positron-Emission Tomography and Computed Tomography / methods* Radiopharmaceuticals / diagnostic use* Recombinant Proteins / diagnostic use Retrospective Studies Sensitivity and Specificity Thyroglobulin / blood Thyroid Neoplasms / blood, radionuclide imaging* Thyrotropin Alfa / diagnostic use* Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Radiopharmaceuticals; 0/Recombinant Proteins; 0/Thyrotropin Alfa; 63503-12-8/Fluorodeoxyglucose F18; 9010-34-8/Thyroglobulin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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