Comparison of whole-body 18 F-FDG PET, 99m Tc-MIBI SPET, and post-therapeutic 131 I-Na scintigraphy in the detection of metastatic thyroid cancer

Progressive dedifferentiation of thyroid cancer cells leads to a loss of iodine-concentrating ability, with resultant false negative, whole body radioactive iodine scans in approximately 20% of all differentiated metastatic thyroid cancer lesions. We tested the hypothesis that all metastatic thyroid cancer lesions that did not concentrate iodine, but did produce thyroglobulin (Tg), could be localized by [18F]2-fluoro-2-deoxy-d-glucose (FDG)-positron emission tomography (PET). We performed FDG-PET on 37 patients with differentiated thyroid cancer after surgery and radioiodine ablation who had negative diagnostic 131I whole body scans during routine follow-up. Serum Tg, Tg autoantibodies, neck ultrasounds, and other clinically indicated imaging procedures were performed to detect residual disease. In those with elevated Tg levels, FDG-PET localized occult disease in 71%, was false positive in one, and was false negative in five patients. The majority of false negative FDG-PET occurred in patients with minimal cervical adenopathy. Surgical resections, biopsies, 131I therapy, and differentiation therapy were performed based on the PET results. The FDG-PET result changed the clinical management in 19 of the 37 patients. In patients with elevated Tg levels, FDG-PET had a positive predictive value of 92%. In patients with low Tg levels, FDG-PET had a negative predictive value of 93%. No FDG-PET scans were positive in stage I patients; however, they were always positive in stage IV patients with elevated Tg levels. An elevated TSH level (i.e. hypothyroidism) did not increase the ability to detect lesions. FDG-PET is able to localize residual thyroid cancer lesions in patients who have negative diagnostic 131I whole body scans and elevated Tg levels, although it was not sensitive enough to detect minimal residual disease in cervical nodes.

Download Full-text

Comparison of 131I whole-body imaging, 131I SPECT/CT, and 18F-FDG PET/CT in the detection of metastatic thyroid cancer

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-011-1809-x ◽

2011 ◽

Vol 38 (8) ◽

pp. 1459-1468 ◽

Cited By ~ 34

Author(s):

Jong-Ryool Oh ◽

Byung-Hyun Byun ◽

Sun-Pyo Hong ◽

Ari Chong ◽

Jahae Kim ◽

...

Keyword(s):

Thyroid Cancer ◽

Fdg Pet ◽

Whole Body ◽

Whole Body Imaging ◽

Body Imaging ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Metastatic Thyroid Cancer

Download Full-text

18F-FDG PET in the Management of Differentiated Thyroid Cancer in Patients with High Serum Thyroglobulin and Negative I-131 Whole Body Scan.

10.1210/endo-meetings.2010.part1.p12.p1-573 ◽

2010 ◽

pp. P1-573-P1-573

Author(s):

R G Martins ◽

A P Santos ◽

J Couto ◽

A P Barbosa ◽

J Teixeira ◽

...

Keyword(s):

Thyroid Cancer ◽

Fdg Pet ◽

Differentiated Thyroid Cancer ◽

High Serum ◽

Whole Body ◽

Whole Body Scan ◽

Body Scan ◽

Serum Thyroglobulin ◽

18F Fdg

Download Full-text

Incremental diagnostic value of [18F]tetrafluoroborate PET-CT compared to [131I]iodine scintigraphy in recurrent differentiated thyroid cancer

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-020-04727-9 ◽

2020 ◽

Vol 47 (11) ◽

pp. 2639-2646 ◽

Cited By ~ 2

Author(s):

Matthias Dittmann ◽

José Manuel Gonzalez Carvalho ◽

Kambiz Rahbar ◽

Michael Schäfers ◽

Michael Claesener ◽

...

Keyword(s):

Thyroid Cancer ◽

Fdg Pet ◽

Differentiated Thyroid Cancer ◽

Imaging Techniques ◽

Diagnostic Value ◽

Whole Body ◽

Sodium Iodide Symporter ◽

Cervical Lymph Nodes ◽

Pet Ct ◽

Fdg Pet Ct

Abstract Introduction Efficient therapy of recurrent differentiated thyroid cancer (DTC) is dependent on precise molecular imaging techniques targeting the human sodium iodide symporter (hNIS), which is a marker both of thyroid and DTC cells. Various iodine isotopes have been utilized for detecting DTC; however, these come with unfavorable radiation exposure and image quality ([131I]iodine) or limited availability ([124I]iodine). In contrast, [18F]tetrafluoroborate (TFB) is a novel radiolabeled PET substrate of hNIS, results in PET images with high-quality and low radiation doses, and should therefore be suited for imaging of DTC. The aim of the present study was to compare the diagnostic performance of [18F]TFB-PET to the clinical reference standard [131I]iodine scintigraphy in patients with recurrent DTC. Methods Twenty-five patients with recurrent DTC were included in this retrospective analysis. All patients underwent [18F]TFB-PET combined with either CT or MRI due to newly discovered elevated TG levels, antiTG levels, sonographically suspicious cervical lymph nodes, or combinations of these findings. Correlative [131I]iodine whole-body scintigraphy (dxWBS) including SPECT-CT was present for all patients; correlative [18F]FDG-PET-CT was present for 21 patients. Histological verification of [18F]TFB positive findings was available in 4 patients. Results [18F]TFB-PET detected local recurrence or metastases of DTC in significantly more patients than conventional [131I]iodine dxWBS and SPECT-CT (13/25 = 52% vs. 3/25 = 12%, p = 0.002). The diagnosis of 6 patients with cervical lymph node metastases that showed mildly increased FDG metabolism but negative [131I]iodine scintigraphy was changed: [18F]TFB-PET revealed hNIS expression in the metastases, which were therefore reclassified as only partly de-differentiated (histological confirmation present in two patients). Highest sensitivity for detecting recurrent DTC had the combination of [18F]TFB-PET-CT/MRI with [18F]FDG-PET-CT (64%). Conclusion In the present cohort, [18F]TFB-PET shows higher sensitivity and accuracy than [131I]iodine WBS and SPECT-CT in detecting recurrent DTC. The combination of [18F]TFB-PET with [18F]FDG-PET-CT seems a reasonable strategy to characterize DTC tumor manifestations with respect to their differentiation and thereby also individually plan and monitor treatment. Future prospective studies evaluating the potential of [18F]TFB-PET in recurrent DTC are warranted.

Download Full-text

Correction to: [18F]-FDG-PET/CT and [18F]-FAZA-PET/CT Hypoxia Imaging of Metastatic Thyroid Cancer: Association with Short-Term Progression after Radioiodine Therapy

Molecular Imaging and Biology ◽

10.1007/s11307-020-01525-5 ◽

2020 ◽

Vol 22 (6) ◽

pp. 1621-1621

Author(s):

Masatoyo Nakajo ◽

Megumi Jinguji ◽

Atsushi Tani ◽

Yoriko Kajiya ◽

Tooru Nandate ◽

...

Keyword(s):

Thyroid Cancer ◽

Fdg Pet ◽

Radioiodine Therapy ◽

Hypoxia Imaging ◽

Short Term ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Metastatic Thyroid Cancer

Download Full-text

Faculty Opinions recommendation of [18F]-FDG-PET/CT and [18F]-FAZA-PET/CT Hypoxia Imaging of Metastatic Thyroid Cancer: Association with Short-Term Progression After Radioiodine Therapy.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.739791364.793584045 ◽

2021 ◽

Author(s):

Sissy Jhiang

Keyword(s):

Thyroid Cancer ◽

Fdg Pet ◽

Radioiodine Therapy ◽

Hypoxia Imaging ◽

Short Term ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct ◽

Metastatic Thyroid Cancer

Download Full-text

Applying new clinicopathological characteristics to prognostication in advanced thyroid carcinoma

Endocrine Related Cancer ◽

10.1530/erc-11-0371 ◽

2012 ◽

Vol 19 (2) ◽

pp. C19-C22 ◽

Cited By ~ 7

Author(s):

Maria E Cabanillas ◽

Steven I Sherman

Keyword(s):

Thyroid Cancer ◽

Fdg Pet ◽

Clinicopathological Characteristics ◽

Emission Tomography ◽

Patients With Cancer ◽

Positron Emission ◽

Pet Scanning ◽

Metastatic Thyroid Cancer

In the February 2011 issue of Endocrine-Related Cancer, Deandreis et al. reported that increased FDG uptake was prognostic in patients with metastatic thyroid cancer. Fludeoxyglucose-positron emission tomography (FDG-PET) is routinely used in the staging and follow-up of patients with cancer. This study gives further evidence for the role of FDG-PET scanning in metastatic thyroid cancer, especially to identify patients with aggressive disease requiring systemic therapy.

Download Full-text