The role of 18 F-FDG-PET/CT in the management of differentiated thyroid cancer.

Autor:	Haidar M; Nuclear Medicine Division, Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut., Kassas M; Nuclear Medicine Division, Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut., Chehade F; Faculty of Medical Sciences, Lebanese University, Hadath., Chahinian R; Department of Diagnostic Imaging, Mount Lebanon Hospital University Medical Center, Hazmiyeh., Abi-Ghosn J; Faculty of Medical Sciences, Lebanese University, Hadath.; Department of Diagnostic Imaging, Mount Lebanon Hospital University Medical Center, Hazmiyeh., Haddad MM; Department of Diagnostic Imaging, Mount Lebanon Hospital University Medical Center, Hazmiyeh.; Faculty of Medicine and Medical Sciences, University of Balamand, Balamand, Lebanon.
Jazyk:	angličtina
Zdroj:	Nuclear medicine communications [Nucl Med Commun] 2023 Nov 01; Vol. 44 (11), pp. 1046-1052. Date of Electronic Publication: 2023 Sep 14.
DOI:	10.1097/MNM.0000000000001758
Abstrakt:	Introduction: In previous literature, 18 F-FDG-PET/ CT imaging significantly impacted differentiated thyroid cancer (DTC) therapy. Low thyroglobulin (Tg) levels and negative Iodine-131 (131I) whole-body scan (WBS), along with negative 18 F-FDG-PET/ CT, suggested a lesser likelihood of active illness. Positive 18 F-FDG-PET/CT findings, however, were associated with a variety of signs of local recurrence and regional or distant metastases in patients with suspected WBS. We aim to evaluate the utility of 18 F-FDG-PET/CT in managing DTC patients with negative 131I post-therapy WBS and elevated Tg. Material and Methods: We retrospectively reviewed 55 patients with DTC (76% papillary and 24% follicular). Patients underwent total thyroidectomy or several radioactive iodine (RAI) treatments or both. WBS was performed 5-7 days after RAI treatment. Inclusion criteria were elevated serum Tg, negative anti-Tg auto-antibodies (AbTg) during long-term follow-up, presence of 18F-FDG-PET/CT images, and negative or suspicious WBS. Results: 54% of 18 F-FDG-PET/CTs detected at least one lesion, mainly, cervical lymph nodes (49.9%), mediastinal lymph nodes (40.4%), local recurrence (34%), and bone or tissue metastasis (36.2%). The three major sites of metastasis were lung, bone, and liver. 18 F-FDG-PET/CT identified recurrence or metastasis in 45% of patients with high serum Tg and negative WBS, modifying therapeutic management in half the patients for suitable treatment modality (surgery vs. tyrosine kinase inhibitor). Conclusion: The findings redemonstrate that elevated Tg with negative or suspicious WBS necessitates 18 F-FDG-PET/CT for localization of recurrence. 18 F-FDG-PET/CT is useful in managing locally recurrent or metastatic DTC with high Tg levels. It influences treatment and accurately assesses disease severity. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu