Document Detail


The role of TSH for 18F-FDG-PET in the diagnosis of recurrence and metastases of differentiated thyroid carcinoma with elevated thyroglobulin and negative scan: a meta-analysis.
MedLine Citation:
PMID:  20484385     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To establish the effects of TSH stimulation on the uptake of fluorine-18-labeled 2-fluoro-2-deoxy-d-glucose for differentiated thyroid carcinoma (DTC) with thyroglobulin-positive and scan negative metastases. MATERIALS AND METHODS: We searched the MEDLINE, EMBASE and the Cochrane Library for prospective controlled trials using TSH stimulation as an intervention. The outcomes of positron emission tomography (PET)-positive lesions, tumor-to-background ratio, maximum standard uptake value of the detected lesions were extracted and synthesized, and patients with the altered clinical management were studied. A meta-analysis was carried out using the Review Manager software. RESULTS: Seven prospective controlled clinical trials with 168 patients were found. All studies had a low risk of bias. PET scans under TSH stimulation versus thyroid hormone suppression showed statistically significant differences in the number of patients with PET true-positive lesions (odds ratio (OR) 2.45, 95% confidence interval (CI) 1.23-4.90) and in the number of the PET-detected lesions (OR 4.92, 95% CI 2.70-8.95) and tumor-to-background ratios. PET scans taken under TSH stimulation altered clinical management in altogether 12/130 (9%) patients in five paired studies (OR 2.40, 95% CI 1.11-5.22). CONCLUSION: The data indicate that TSH stimulation should be recommended for DTC patients undergoing PET scanning in these circumstances. However, further well-designed studies emphasizing on the clinical significance of altered management by PET under TSH stimulation are needed.
Authors:
Chao Ma; Jiawei Xie; Yanhui Lou; Yanyan Gao; Shuyao Zuo; Xufu Wang
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't     Date:  2010-05-19
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  163     ISSN:  1479-683X     ISO Abbreviation:  Eur. J. Endocrinol.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-27     Completed Date:  2010-08-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  England    
Other Details:
Languages:  eng     Pagination:  177-83     Citation Subset:  IM    
Affiliation:
Department of Nuclear Medicine, Affiliated Hospital of Medical College Qingdao University, Qingdao, Shandong Province, People's Republic of China. mc_7419@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Carcinoma / blood,  radionuclide imaging*
Fluorodeoxyglucose F18 / diagnostic use*
Humans
Odds Ratio
Thyroglobulin / blood
Thyroid Neoplasms / blood,  radionuclide imaging*
Thyrotropin / diagnostic use*
Chemical
Reg. No./Substance:
63503-12-8/Fluorodeoxyglucose F18; 9002-71-5/Thyrotropin; 9010-34-8/Thyroglobulin

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


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