Follow-up of Differentiated Thyroid Cancer: What is the Value of FDG and Sestamibi in the Diagnostic Algorithm?

1998 ◽  
Vol 37 (01) ◽  
pp. 06-11 ◽  
Author(s):  
K. Scheidhauer ◽  
E. Voth ◽  
P. Theissen ◽  
H. Schicha ◽  
M. Dietlein
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Fdg Pet ◽  
Differentiated Thyroid Cancer ◽  
Pulmonary Metastases ◽  
Follicular Carcinoma ◽  
Spiral Ct ◽  
Whole Body ◽  
Mibi Scintigraphy

Summary Aim: FDG-PET and MIBI-scintigraphy with SPECT were compared to [131I]-whole-body scintigraphy (WBS) and morphologic imaging in the follow-up of differentiated thyroid cancer. Their influence on therapy-planning was analysed. Methods: In 50 consecutive patients (papillary/ follicular/variants of a follicular carcinoma: 33/13/4; primary status: pTI/2/3/4: 3/16/9/22) FDG-PET of neck/chest and MIBI-whole-body scan including SPECT were performed during hypothyreosis and before WBS. Morphologic imaging was done by MRI in all and by CT of the lung without contrast media in 21 patients. Results: The complete extent of metastases was detected by FDG-PET in 11 and by MIBI-scintigraphy also in 11 of 22 patients with evidence of disease. The combined evaluation of WBS and FDG-PET as well as of WBS and MIBI-scintigraphy held true in 18 of 22 patients. Limiting FDG-PET or MIBI-scintigraphy to patients with elevated thyroglobulin (Tg)-levels and negative WBS only, would not, therefore, alter the sensitivity of this algorithm. The diagnostic benefit of FDG-PET and MIBI-scintigraphy was confined to lymph node metastases. The 1 cm limit for lymph node size in morphologically based imaging did not apply to FDG-PET and MIBI-scintigraphy. None of the 6 patients with small (<1 cm) pulmonary metastases showed either FDG- or MIBI-uptake, but could be diagnosed by spiral-CT. Conclusion: WBS cannot be replaced by FDG-PET or MIBI-scintigraphy; neither of the latter was better than the other. Rising Tg-levels, negative WBS and the exclusion of pulmonary metastases by spiral-CT define the constellation in which FDG-PET and MIBI-scintigraphy can provide data of therapeutic relevance.

FDG-PET, I-131 and MIBI Scintigraphy in the Follow-Up of Differentiated Thyroid Cancer

1997 ◽  
pp. 63-68
Author(s):  
F. Grünwald ◽  
H.-J. Biersack ◽  
E. Klemm ◽  
C. Menzel ◽  
H. Bender ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Fdg Pet ◽  
Differentiated Thyroid Cancer ◽  
Mibi Scintigraphy

scholarly journals Serum thyroglobulin and 131I whole body scan after recombinant human TSH stimulation in the follow-up of low-risk patients with differentiated thyroid cancer

2003 ◽  
pp. 19-24 ◽  
Author(s):  
M Torlontano ◽  
U Crocetti ◽  
L D'Aloiso ◽  
N Bonfitto ◽  
A Di Giorgio ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Thyroid Hormone ◽  
Differentiated Thyroid Cancer ◽  
Whole Body ◽  
Whole Body Scan ◽  
Serum Thyroglobulin ◽  
Risk Patients ◽  
Node Metastases

OBJECTIVE: The 'standard' postoperative follow-up of patients with differentiated thyroid cancer (DTC) has been based upon serum thyroglobulin (Tg) measurement and (131)I whole body scan ((131)I-WBS) after thyroid hormone (T(4)) treatment withdrawal. However, (131)I-WBS sensitivity has been reported to be low. Thyroid hormone withdrawal, often associated with hypothyroidism-related side effects, may now be replaced by recombinant human thyroid stimulating hormone (rhTSH). The aim of our study was to evaluate the diagnostic accuracy of (131)I-WBS and serum Tg measurement obtained after rhTSH stimulation and of neck ultrasonography in the first follow-up of DTC patients. DESIGN: Ninety-nine consecutive patients previously treated with total thyroidectomy and (131)I ablation, with no uptake outside the thyroid bed on the post-ablative (131)I-WBS (low-risk patients) were enrolled. METHODS: Measurement of serum Tg and (131)I-WBS after rhTSH stimulation, and ultrasound examination (US) of the neck. RESULTS: rhTSH-stimulated Tg was <or=1 ng/ml in 78 patients (Tg-) and >1 ng/ml (Tg+) in 21 patients, including 6 patients with Tg levels >5 ng/ml. (131)I-WBS was negative for persistent or recurrent disease in all patients (i.e. sensitivity = 0%). US identified lymph-node metastases (confirmed at surgery) in 4/6 (67%) patients with stimulated Tg levels >5 ng/ml, in 2/15 (13%) with Tg>1<5 ng/ml, and in 2/78 (3%) who were Tg-negative. CONCLUSIONS: (i) diagnostic (131)I-WBS performed after rhTSH stimulation is useless in the first follow-up of DTC patients; (ii) US may identify lymph node metastases even in patients with low or undetectable serum Tg levels.

scholarly journals Evolution of differentiated thyroid cancer during pregnancy in a community University Hospital in Buenos Aires, Argentina

2013 ◽  
Vol 57 (4) ◽  
pp. 307-311 ◽  
Author(s):  
Carmen Amalia Cabezón ◽  
Laura Carolina Carrizo ◽  
Pablo René Costanzo
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Tumor Size ◽  
Differentiated Thyroid Cancer ◽  
Whole Body ◽  
Group I ◽  
Node Metastases ◽  
Group Ii

OBJECTIVE: To analyze the presentation, follow-up and evolution of differentiated thyroid cancer (DTC) detected during pregnancy. SUBJECTS AND METHODS: Twenty nine women with DTC detected during pregnancy were analyzed. Group I (n = 13) was seen during pregnancy and DTC was diagnosed during gestation; detection of the nodule occurred during pregnancy (first trimester). Group II (n = 16) was seen after delivery; detection of the nodule occurred during pregnancy (second or third trimester). Complete thyroidectomy, ablative dose of radioactive iodine, and treatment with levothyroxine were performed. Follow-up: neck ultrasound; TSH, free T4, thyroglobulin, and anti-thyroglobulin antibodies with and without treatment with levothyroxine; and 131I whole body scans. Histological diagnosis, lymph node metastases, tumor size and stage, complications from pregnancy, and DTC evolution were evaluated. RESULTS: 100% of the patients had papillary thyroid carcinoma. Lymph node metastases were detected in 13 (44.8%), and invasion of adjacent extrathyroid tissue in 2 patients. Tumor size was larger in Group II: 22.1 ± 10.9 versus 13.9 ± 3.5 mm; p = 0.03. No differences were found in the tumor stages between groups. All patients had full-term pregnancies and healthy newborns. Follow-up: 5.7 ± 4.3 years; one patient had persistent disease. CONCLUSIONS: DTC detected during pregnancy had a favorable evolution. Surgery may be postponed to the post-delivery period, unless there are risk factors that justify it during pregnancy.

scholarly journals The role of FDG-PET in localization of recurrent lesions of differentiated thyroid cancer (DTC) in patients with asymptomatic hyperthyroglobulinemia in a real clinical practice

2016 ◽  
Vol 175 (5) ◽  
pp. 379-385 ◽  
Author(s):  
A Kukulska ◽  
J Krajewska ◽  
Z Kołosza ◽  
E Paliczka-Cies´lik ◽  
Z Puch ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Fdg Pet ◽  
Differentiated Thyroid Cancer ◽  
Prognostic Significance ◽  
Whole Body ◽  
Asymptomatic Patients ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Tsh Stimulation

IntroductionAvailable methods, including serum thyroglobulin (Tg) measurement and whole-body scan (WBS) performed after radioiodine administration, allow for a precise diagnostics in differentiated thyroid cancer (DTC). However, some asymptomatic patients demonstrate negative WBS despite a high Tg serum concentration. In these subjects, fluorodeoxyglucose-positron emission tomography (FDG-PET) should be considered. The primary aim of our study was to evaluate a diagnostic value of FDG-PET in asymptomatic hyperthyroglobulinemia. The secondary one was to determine a prognostic value of a negative FDG-PET result in DTC patients with elevated Tg level.MaterialOne hundred and ten FDG-PET/CT scans were retrospectively analyzed, 85 scans were done under TSH stimulation and 25 on LT4suppressive therapy. Follow-up ranged between 4 and 9 years.ResultsThe first FDG-PET/CT detected cancer foci in 49 subjects with a global sensitivity of 45%. When the sensitivity was evaluated with reference to TSH stimulation and suppression, its values were 50 and 28% respectively. In 42 patients, FDG-PET failed to diagnose the reason for elevated Tg level. During further follow-up, in 17 of them, DTC recurrence was detected by other methods (CT, MRI, US). Fourteen subjects with asymptomatic hyperthyroglobulinemia were free of DTC progression for at least 4 years.ConclusionsFDG-PET in DTC patients with asymptomatic hyperthyroglobulinemia constitutes a valuable diagnostic tool. Negative FDG-PET demonstrated a limited prognostic significance, as only every third patient did not show DTC progression. Moreover, negative FDG-PET does not justify less strict DTC monitoring, because it is related to 40% risk of relapse during the 5-year follow-up.

scholarly journals Pulmonary metastases in differentiated thyroid cancer: efficacy of radioiodine therapy and prognostic factors

2015 ◽  
Vol 173 (3) ◽  
pp. 399-408 ◽  
Author(s):  
Hong-Jun Song ◽  
Zhong-Ling Qiu ◽  
Chen-Tian Shen ◽  
Wei-Jun Wei ◽  
Quan-Yong Luo
Keyword(s):  
Thyroid Cancer ◽  
Prognostic Factors ◽  
Pulmonary Metastasis ◽  
Differentiated Thyroid Cancer ◽  
Radioiodine Therapy ◽  
Pulmonary Metastases ◽  
Lung Metastases ◽  
Whole Body ◽  
Metastatic Node ◽  
Serum Thyroglobulin

ContextData from a large cohort of patients with pulmonary metastases from differentiated thyroid cancer (DTC) were retrospectively analyzed.ObjectiveTo assess the effect of radioiodine therapy and investigate the prognostic factors of survival for patients with pulmonary metastasis secondary to DTC.MethodsA total of 372 patients with pulmonary metastasis from DTC treated with131I entered the study. According to the results of131I whole-body scan (WBS), pulmonary metastases were classified as131I-avid and non-131I-avid. For patients with131I-avid lung metastases, treatment response was measured by three parameters: serum thyroglobulin (Tg) levels, chest computed tomography (CT) and post-therapeutic131I-WBS. Overall survival was calculated by the Kaplan–Meier method. Factors predictive of the outcome were determined by multivariate analyses.ResultsAmong patients demonstrating131I-avid pulmonary metastases (256/372, 68.8%), 156 cases (156/256, 60.9%) showed a significant decrease in serum Tg levels after131I therapy and 138 cases (138/229, 60.3%) showed a reduction in pulmonary metastases on follow-up CT. A complete cure, however, was only achieved in 62 cases (62/256, 24.2%). Multivariate analysis showed that only age, the presence of multiple distant metastases and pulmonary metastatic node size were significant independent variables between the groups of131I-avid and non-131I-avid.ConclusionThis study indicated that, most131I-avid pulmonary metastases from DTC can obtain partial or complete remission after131I therapy. Younger patients (<40 years old) with only pulmonary metastases and small (‘fine miliaric’ or micronodular) metastases appear to have relative favorite outcomes. Patients who do not respond to131I treatment have a worse prognosis.

Long-Term Follow-Up of Patients With Differentiated Thyroid Cancer Who had Negative 131I Whole-Body Scan at First Evaluation After Treatment

2013 ◽  
Vol 38 (10) ◽  
pp. 765-769 ◽  
Author(s):  
Luciana Souza Cruz Caminha ◽  
Denise Prado Momesso ◽  
Fernanda Vaisman ◽  
Rossana Corbo ◽  
Mario Vaisman
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Whole Body ◽  
Whole Body Scan ◽  
Body Scan ◽  
Long Term Follow Up
Sign in / Sign up

Export Citation Format

Share Document