Therapeutic impact of ¹⁸FDG-PET/CT in the management of iodine-negative recurrence of differentiated thyroid carcinoma

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• 作者：Eric Mirallié ; Thomas Guillan ; Boumé ; diene Bridji ; Isabelle Resche ; Caroline Rousseau ; Catherine Ansquer ; Caroline Bodet-Milin ; Chantal Curtet ; Bruno Carnaille ; Arnaud Murat ; Bernard Charbonnel ; Franç ; oise Kraeber-Bodé ; ré
• 刊名：Surgery
• 出版年：2007
• 出版时间：December 2007
• 年：2007
• 卷：142
• 期：6
• 页码：952-958
• 全文大小：1529 K

文摘

Background

18-F-fluoro-2-deoxyglucose positron emission tomography (¹⁸FDG-PET) is useful in the detection of iodine-negative differentiated thyroid carcinoma (DTC). The aim of this prospective study was to assess therapeutic impact of ¹⁸FDG-PET imaging using a PET/computed tomography (CT) system in patients with iodine-negative recurrence of DTC.

Methods

From 2002 to 2006, patients with recurrence of DTC diagnosed by elevated thyroglobulin level and negative 131-I whole-body scan were included.

Results

Forty-five patients (31 women, 14 men), with a mean age of 55 years, with 36 papillary, 5 follicular, and 4 Hürthle carcinomas, were studied. All patients had previously undergone total thyroidectomy and postoperative thyroid remnant ablation with 131-I. The findings of ¹⁸FDG-PET/CT were positive in 31 patients (68.8 % ) and negative in 14 (32.2 % ). Results were true positive in 24 of 31 patients. The sensitivity, positive predictive value, and accuracy of ¹⁸FDG-PET/CT were 63 % , 77 % , and 53 % , respectively. Twenty patients were operated on, 19 had neck surgery with mediastinal lymph node dissection (1 case) and lung resection (1 case), and 1 underwent lung resection. Seven patients had a stimulated thyroglobulin level <1 ng/mL.

Conclusion

¹⁸FDG-PET/CT is able to select patients who can benefit from surgery. Normalization of thyroglobulin is observed in one third of operated patients.