The clinical impact of 18F-FDG gamma PET in patients with recurrent well differentiated thyroid carcinoma
| Autor: | Galina Rotenberg, A Karasik, S. Zwas, Elinor Goshen, Y. Oksman, O. Cohen |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Mediastinal Neoplasms Whole-Body Counting Thyroid carcinoma Fluorodeoxyglucose F18 Carcinoma Medicine Humans Radiology Nuclear Medicine and imaging Gamma Cameras Thyroid Neoplasms Radiation treatment planning Thyroid cancer Aged medicine.diagnostic_test business.industry General Medicine Middle Aged medicine.disease Carcinoma Papillary Clinical trial Treatment Outcome Positron emission tomography Head and Neck Neoplasms Thyroglobulin Whole Body Scan Female Radiology Neoplasm Recurrence Local Radiopharmaceuticals business Nuclear medicine Tomography Emission-Computed |
| Zdroj: | Nuclear medicine communications. 24(9) |
| ISSN: | 0143-3636 |
| Popis: | The therapeutic approach to recurrent well-differentiated thyroid cancer is based on the detection of active disease. While a measured increase of thyroglobulin level in an ablated patient is highly suggestive of recurrence, localization of the tumour is necessary for adequate treatment planning. A whole body scan with 131I yields false negative results in the presence of non-iodophyllic foci of disease. Hypermetabolic foci of differentiated thyroid carcinoma can be detected by gamma PET with 2-[18F]fluoro-2-deoxy-D-glucose (18F-FDG). This study retrospectively evaluated the therapeutic impact of the 18F-FDG scan in patients with suspected recurrent thyroid carcinoma in whom the iodine scan was negative. Twenty patients (five male, 15 female) aged 19-77 years, were suspected of having recurrent thyroid carcinoma due to elevated thyroglobulin levels and/or palpable neck findings. All whole body iodine scans obtained with diagnostic doses (74-148 MBq (2-4 mCi) of 131I), were reported normal, i.e., no iodophyllic foci were detected. Whole body gamma positron emission tomography (PET) imaging was performed in fasting patients following i.v. administration of 370 MBq (10 mCi) 18F-FDG, with a strict 1 h immobilization post-injection. Gamma PET results were validated either by anatomical imaging, repeat iodine scanning after administration of a therapeutic dose (at least 3,700 MBq (100 mCi) of 131I) or surgery. The impact of the FDG scan on patient management was evaluated by the referring physicians. Positive gamma PET results confirmed the presence of active disease in 14/15 patients. One false positive finding (fibrosis) and one false negative (carcinoid) were reported. Localization of hypermetabolic foci supported treatment decisions in 10 patients, and significantly altered therapeutic management in six others. Treatment was withheld in four patients with negative findings. The clinical impact of the scan in this patient group is similar to that reported in the literature and justifies its future implementation. |
| Databáze: | OpenAIRE |
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