Document Detail


Utility of PET/neck MRI digital fusion images in the management of recurrent or persistent thyroid cancer.
MedLine Citation:
PMID:  18279011     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Approximately 30% of thyroid cancer patients present with reappearing disease within 40 years of initial diagnosis. Hence, sensitive postsurgical monitoring techniques are imperative to successful long-term care. The objective of this study was to assess the added clinical utility of a combined positron emission tomography/magnetic resonance imaging (PET/MRI) of the neck in conjunction with standard imaging in the detection of recurrent thyroid carcinoma. We define standard imaging as a neck sonogram, 131I scan, computed tomography, and MRI. METHODS: This study included 34 patients treated for thyroid cancer at Washington Hospital Center. All patients had previously undergone near-total or total thyroidectomy, standard follow-up imaging studies, and laboratory studies. Twenty-nine of thirty-four patients had received at least one 131I treatment prior to the study. Each patient received a PET and MRI scan, and these images were subsequently digitally fused. RESULTS: Individually and blinded, four endocrinologists retrospectively reviewed all information in patient charts prior to PET and PET/MRI coregistration. A clinical assessment and treatment plan were devised with these data. Following the initial assessment, the endocrinologists were provided results from the PET and PET/MRI fusion studies and asked to make a revised assessment and treatment plan. For each patient, the physicians categorized PET/MRI fusion results as providing new information that altered the initial treatment plan, providing new information that confirmed the initial treatment plan, or providing no additional information. On average, PET/MRI coregistration provided additional information that altered the treatment plan in 46% of the cases, provided additional information that confirmed the treatment plan in 36% of cases, and did not provide any additional information in 18% of cases. CONCLUSION: The combination of structural and functional data that PET/neck MRI fusion offers provided further information in an overwhelming majority of thyroid cancer patients in this study. Thus PET/MRI can be a useful tool in surgical planning, radioactive iodine therapy decisions, and determining the level of follow-up necessary for each patient.
Authors:
Laura Seiboth; Douglas Van Nostrand; Leonard Wartofsky; Yasser Ousman; Jacqueline Jonklaas; Calvin Butler; Frank Atkins; Kenneth Burman
Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Thyroid : official journal of the American Thyroid Association     Volume:  18     ISSN:  1050-7256     ISO Abbreviation:  Thyroid     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-18     Completed Date:  2008-04-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9104317     Medline TA:  Thyroid     Country:  United States    
Other Details:
Languages:  eng     Pagination:  103-11     Citation Subset:  IM    
Affiliation:
Endocrine Medicine Section, Washington Hospital Center, Georgetown University Medical Center, Washington, DC 20010, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Carcinoma, Papillary / pathology*,  radionuclide imaging,  therapy
Female
Fluorodeoxyglucose F18 / diagnostic use
Humans
Image Interpretation, Computer-Assisted
Iodine Radioisotopes / diagnostic use,  therapeutic use
Magnetic Resonance Imaging*
Male
Middle Aged
Neoplasm Recurrence, Local*
Patient Selection*
Positron-Emission Tomography*
Predictive Value of Tests
Radiopharmaceuticals / diagnostic use
Retrospective Studies
Signal Processing, Computer-Assisted*
Thyroid Neoplasms / pathology*,  radionuclide imaging,  therapy
Thyroidectomy
Tomography, X-Ray Computed
Treatment Outcome
Ultrasonography
Chemical
Reg. No./Substance:
0/Iodine Radioisotopes; 0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18

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


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