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

Overview

Journal Br J Radiol

Publisher Oxford University Press

Specialty Radiology

Date 2012 Sep 14

PMID 22972977

Citations 4

Authors

R J D Prestwich

S Viner

G Gerrard

C N Patel

A F Scarsbrook

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

TSH Stimulation before PET/CT as Our Frenemy in Detecting Thyroid Cancer Metastases-Final Results of a Retrospective Analysis.

Kolodziej M, Saracyn M, Lubas A, Brodowska-Kania D, Mazurek A, Dziuk M Cancers (Basel). 2024; 16(19).

PMID: 39410032 PMC: 11475661. DOI: 10.3390/cancers16193413.

Usefulness of PET/CT with F-FDG in Patients with Differentiated Thyroid Carcinoma after Radioiodine Therapy: An Italian Multicenter Study.

Filippi L, Frantellizzi V, Monari F, Lodi Rizzini E, Tabacchi E, Pirisino R Diagnostics (Basel). 2021; 11(7).

PMID: 34359347 PMC: 8306511. DOI: 10.3390/diagnostics11071264.

Usefulness of PET-CT scan in recurrent thyroid cancer.

Dionigi G, Fama F, Pignata S, Pino A, Pontin A, Caruso E World J Otorhinolaryngol Head Neck Surg. 2020; 6(3):182-187.

PMID: 33073214 PMC: 7548382. DOI: 10.1016/j.wjorl.2020.02.008.

F18-FDG-PET for recurrent differentiated thyroid cancer: a systematic meta-analysis.

Haslerud T, Brauckhoff K, Reisaeter L, Lein R, Heinecke A, Varhaug J Acta Radiol. 2015; 57(10):1193-200.

PMID: 26163534 PMC: 5015757. DOI: 10.1177/0284185115594645.

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