Pre-Ablation rhTSH-Stimulated F-18 FDG PET/CT Changes Patient Management in Increased-Risk Thyroid Cancer
| Autor: | Lukas Hehenwarter, Lukas Rettenbacher, Gregor Schweighofer-Zwink, Christian Pirich, Gundula Rendl |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment Clinical Biochemistry Whole body imaging 030209 endocrinology & metabolism 030204 cardiovascular system & hematology Biochemistry Papillary thyroid cancer Iodine Radioisotopes Thyroid carcinoma 03 medical and health sciences 0302 clinical medicine Endocrinology Fluorodeoxyglucose F18 Positron Emission Tomography Computed Tomography Internal medicine Humans Medicine Whole Body Imaging Thyroid Neoplasms Thyrotropin Alfa Thyroid cancer Lymph node Retrospective Studies Fluorodeoxyglucose business.industry Biochemistry (medical) Thyroidectomy General Medicine Middle Aged medicine.disease medicine.anatomical_structure Female Thyroglobulin business Nuclear medicine medicine.drug |
| Zdroj: | Hormone and Metabolic Research. 52:158-167 |
| ISSN: | 1439-4286 0018-5043 |
| Popis: | The aim of the study was to evaluate the clinical impact of pre-ablation rhTSH-stimulated fluorine-18 fluorodeoxyglucose (F-18 FDG) PET/CT in addition to post-therapeutic whole body radioiodine scanning in patients with intermediate to high risk differentiated thyroid carcinoma (DTC). This was a retrospective single center study including 73 patients with thyroid cancer (44 females, mean age 43.2±16.2 years, 62% papillary, 31% follicular, 7% poorly differentiated). All patients underwent ablative radioiodine treatment (mean activity: 3661±673 MBq I-131) using rhTSH after thyroidectomy and lymph node (LN) dissection (01/2013–10/2016) and TSH-stimulated F-18 FDG PET/CT (4 MBq/kg body weight, low dose CT). Post-treatment I-131 whole body scan (I-131 WBS) was obtained 9 days afterwards in planar technique and in case of equivocal or abnormal findings using SPECT/CT. Thirty-one patients (42%) showed F-18 FDG avid lesions, 14 patients showed more FDG than iodine positive lesions and 5 patients more iodine positive lesions in I-131 WBS, respectively. Fifty-three patients showed identical F-18 FDG PET/CT and I-131 WBS. The initial treatment plan was changed from follow-up to therapy (surgery, systemic therapy using tyrosine-kinase inhibition) in 11 patients (15%) on the basis of F-18 FDG PET/CT imaging. Six of these 11 patients had papillary thyroid cancer. Three patients with histologically proven LN metastases had stimulated thyroglobulin-levels |
| Databáze: | OpenAIRE |
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