The role of early 18F-FDG PET/CT in therapeutic management and ongoing risk stratification of high/intermediate-risk thyroid carcinoma

Autor: E. M. Triviño Ibáñez, J. M. Llamas Elvira, M. A. Muros, E. Torres Vela
Rok vydání: 2015
Předmět:
Adult
Male
medicine.medical_specialty
Thyroid Hormones
Time Factors
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Whole body imaging
Risk Assessment
030218 nuclear medicine & medical imaging
Thyroid carcinoma
03 medical and health sciences
Young Adult
0302 clinical medicine
Endocrinology
Fluorodeoxyglucose F18
Positron Emission Tomography Computed Tomography
Medicine
Combined Modality Therapy
Humans
Whole Body Imaging
Prospective Studies
Thyroid Neoplasms
Prospective cohort study
Aged
Aged
80 and over
Tomography
Emission-Computed
Single-Photon
medicine.diagnostic_test
business.industry
Thyroidectomy
Disease Management
Reproducibility of Results
Middle Aged
Ablation
Treatment Outcome
Positron emission tomography
030220 oncology & carcinogenesis
Lymph Node Excision
Female
Radiology
Radiopharmaceuticals
business
Risk assessment
Nuclear medicine
Zdroj: Endocrine. 51(3)
ISSN: 1559-0100
Popis: Little is known about the role in ongoing risk stratification of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) performed early after radioactive iodine (RAI) ablation in differentiated thyroid carcinoma (DTC). The aim of the study is to investigate whether 18F-FDG PET/CT performed early after RAI ablation is useful to detect disease and to influence therapy and ongoing risk stratification. Patients with high/intermediate risk of recurrent DTC were included. 18F-FDG PET/CT scan was performed within 6 months after RAI ablation. We confirmed results with other imaging techniques, pathology reports, or follow-up. We classified the patient response as excellent, acceptable, or incomplete. Modified Hicks criteria were used to evaluate clinical impact. We included 81 patients with high/intermediate risk of recurrent DTC. Forty-one (50.6%) had positive uptake in 18F-FDG PET/CT, with negative (131)I whole-body scan ((131)I WBS). Sensitivity, specificity, and diagnostic accuracy of 18F-FDG PET/CT were 92.5, 90.2, and 91.4%, respectively. 18F-FDG PET/CT results had an impact on therapy in 38.3% of patients. One year after initial therapy, 45.7% showed excellent response, 8.6% acceptable response, and 45.7% incomplete response. A statistically significant relationship was found between negative 18F-FDG PET/CT and excellent response (80 vs. 12.2%, p < 0.001; OR 52.8). 18F-FDG PET/CT scan performed early in surveillance of patients with high/intermediate-risk thyroid carcinoma provides important additional information not available with conventional follow-up methods and had a high impact on therapy. A negative 18F-FDG PET/CT predicts an excellent response to therapy in the new ongoing risk stratification.
Databáze: OpenAIRE
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