Accuracy of positron emission tomography and positron emission tomography-CT in the detection of differentiated thyroid cancer recurrence with negative131I whole-body scan results: A meta-analysis

Head & Neck ◽  
2015 ◽  
Vol 38 (2) ◽  
pp. 316-327 ◽  
Author(s):  
Rosângela Caetano ◽  
Cláudia Regina Garcia Bastos ◽  
Ione Ayala Gualandi de Oliveira ◽  
Rondineli Mendes da Silva ◽  
Clarisse Pereira Dias Drumond Fortes ◽  
...  
2009 ◽  
Vol 123 (10) ◽  
pp. 1145-1149
Author(s):  
E J Chisholm ◽  
N S Tolley

AbstractBackground:Follow up of patients with differentiated thyroid cancer is based upon anatomical imaging, thyroglobulin assay and functional imaging in the form of iodine uptake scanning. A significant cohort of such patients have rising thyroglobulin levels but negative iodine scans. In this group, 18fluoro-2-deoxyglucose positron emission tomography scans have been commonly employed. The aim of this study was to assess the usefulness of such investigation.Methods:The sensitivity of 18fluoro-2-deoxyglucose positron emission tomography for detecting recurrence of differentiated thyroid cancer was calculated from a retrospective review of scan results from patients with iodine scan negative recurrence.Results:Eighteen patients with rising thyroglobulin levels underwent 18fluoro-2-deoxyglucose positron emission tomography scanning. Fourteen patients had negative (and four equivocal) whole body iodine scintigraphy scans. Of these 14, six patients had a positive 18fluoro-2-deoxyglucose positron emission tomography scan, giving a sensitivity of 42.9 per cent.Conclusions:When assessed in the clinical setting and restricted to patients with negative iodine scans, the sensitivity of 18fluoro-2-deoxyglucose positron emission tomography was found to be lower than in previous case series.


2007 ◽  
Vol 73 (10) ◽  
pp. 1052-1056
Author(s):  
Micah Roberts ◽  
Ellie Maghami ◽  
Fouad Kandeel ◽  
David Yamauchi ◽  
Hannah-Leeba Ellenhorn ◽  
...  

An elevated thyroglobulin (Tg) level after total thyroidectomy for differentiated thyroid cancer is often associated with disease recurrence. 131I-whole body scans (131I-WBS) and cross-sectional imaging are commonly used to localize occult metastases in these patients. Localizing disease when 131I-WBS are negative and cross-section imaging is equivocal remains a challenge. The medical records of 12 patients with thyroid cancer undergoing positive positron emission tomography (PET) scans for 131I-WBS-negativeTg elevations or the presence of anti-Tg antibodies were identified and charts were reviewed in a retrospective fashion. All had been treated with total thyroidectomy and 131I ablation in the past. Computed tomography, magnetic resonance imaging, or ultrasound studies revealed suspicious lesions in eight patients. All 12 patients underwent resection of the PET-positive lesions. All resections were positive for thyroid cancer in the regions predicted by the positive PET scan. All nine (100%) patients with elevated preoperative Tg levels experienced a reduction in Tg level after resection. PET scans accurately predict the presence of recurrent thyroid cancer when 131I-WBS are negative. PET scans should be considered in the follow up of 131I-WBS-negative patients with thyroid cancer who are suspected of having recurrent disease.


2013 ◽  
Vol 20 (4) ◽  
pp. R203-R213 ◽  
Author(s):  
Kyoungjune Pak ◽  
Seong-Jang Kim ◽  
In Joo Kim ◽  
Bo Hyun Kim ◽  
Sang Soo Kim ◽  
...  

The incidence of thyroid cancer in both men and women is increasing faster than that of any other cancer. Although positron emission tomography (PET) using18F-fluorodeoxyglucose (FDG) has received much attention, the use of FDG PET for the management of thyroid cancer is limited primarily to postoperative follow-up. However, it might have a role in selected, more aggressive pathologies, and so patients at a high risk of distant metastasis may benefit from PET before surgery. As less FDG-avid thyroid cancers may lower the diagnostic accuracy of PET in preoperative assessment, an understanding of FDG avidity is important for the evaluation of thyroid cancer. FDG avidity has been shown to be associated with tumor size, lymph node metastasis, and glucose transporter expression and differentiation. As PET is commonly used in clinical practice, the detection of incidentalomas by PET is increasing. However, incidentalomas detected by PET have a high risk of malignancy. Clinicians handling cytologically indeterminate nodules face a dilemma regarding a procedure for a definitive diagnosis, usually lobectomy. With ‘nondiagnostic (ND)’ fine-needle biopsy (FNA), PET has shown a negative predictive value (NPV) of 100%, which indicates that negative uptake in a ND FNA procedure accurately excludes malignancy. With ‘atypia of undetermined significance’ or ‘follicular neoplasm’, the sensitivity and NPV of PET are 84 and 88%. PET does not provide additional information for the preoperative assessment of thyroid cancer. However, factors associated with FDG positivity are related to a poor prognosis; therefore, FDG PET scans before surgery may facilitate the prediction of the prognosis of differentiated thyroid cancer.


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