Diagnosis of Metastases from Postoperative Differentiated Thyroid Cancer: Comparison between FDG and FLT PET/CT Studies

Autor: Yoshiaki Nakabeppu, Hiroaki Tanabe, Yoriko Kajiya, Atsushi Tani, Chihaya Koriyama, Yoshihiko Fukukura, Masatoyo Nakajo, Megumi Jinguji, Masayuki Nakajo
Rok vydání: 2013
Předmět:
Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Whole body imaging
Multimodal Imaging
Sensitivity and Specificity
Statistics
Nonparametric
Fluorodeoxyglucose F18
Predictive Value of Tests
medicine
Humans
Whole Body Imaging
Radiology
Nuclear Medicine and imaging
Prospective Studies
Thyroid Neoplasms
Prospective cohort study
Lymph node
Thyroid cancer
Aged
Chi-Square Distribution
medicine.diagnostic_test
business.industry
Thyroidectomy
Middle Aged
medicine.disease
Dideoxynucleosides
medicine.anatomical_structure
Positron emission tomography
Lymphatic Metastasis
Positron-Emission Tomography
Predictive value of tests
Radiographic Image Interpretation
Computer-Assisted
Ct technique
Female
Radiology
Neoplasm Recurrence
Local
Radiopharmaceuticals
Tomography
X-Ray Computed
business
Nuclear medicine
Zdroj: Radiology. 267:891-901
ISSN: 1527-1315
0033-8419
Popis: To compare positron emission tomography (PET)/computed tomography (CT) studies performed with the glucose analog fluorine 18 ((18)F) fluorodeoxyglucose (FDG) and the cell proliferation tracer (18)F fluorothymidine (FLT) in the diagnosis of metastases from postoperative differentiated thyroid cancer.The institutional ethics review board approved this prospective study. From March 2010 to February 2012, 20 patients (mean age, 53 years; age range, 22-79 years) with postoperative differentiated thyroid cancer underwent both FDG and FLT PET/CT as a staging work-up before radioiodine therapy. In each patient, 28 anatomic areas were set and analyzed for lymph node and distant metastases. The McNemar exact or χ(2) test was used to examine differences in diagnostic indexes in the detection of lymph node and distant metastases between both tracer PET/CT studies.There were 34 lymph node metastases and/or 73 distant metastases (70 metastases in lung and one each in bone, nasopharynx, and brain) in 13 patients. At patient-based analysis, the sensitivity, specificity, and accuracy were 92% (12 of 13 patients), 86% (six of seven patients), and 90% (18 of 20 patients), respectively, for FDG PET/CT and 69% (nine of 13 patients), 29% (two of seven patients), and 55% (11 of 20 patients) for FLT PET/CT. The accuracy of FDG PET/CT was significantly better than that of FLT PET/CT (P = .023). At lesion-based analysis, the sensitivity, specificity, and accuracy for diagnosing lymph node metastases were 85% (29 of 34 lesions), 99.6% (245 of 246 lesions), and 97.9% (274 of 280 lesions), respectively, for FDG PET/CT and 50% (17 of 34 lesions), 90.7% (223 of 246 lesions), and 85.7% (240 of 280 lesions) for FLT PET/CT. The sensitivity, specificity, and accuracy for diagnosing distant metastases were 45% (33 of 73 lesions), 100% (207 of 207 lesions), and 85.7% (240 of 280 lesions), respectively, for FDG PET/CT and 6.8% (five of 73 lesions), 100% (207 of 207 lesions), and 75.7% (212 of 280 lesions) for FLT PET/CT. The sensitivity (P = .002), specificity (P.001), and accuracy (P.001) of FDG PET/CT in the diagnosis of lymph node metastases were superior to those of FLT PET, as were the sensitivity (P.001) and accuracy (P.001) in the diagnosis of distant metastases.FDG PET/CT is superior to FLT PET/CT in the diagnosis of postoperative differentiated thyroid cancer lymph node and distant metastases. Thus, FDG PET/CT is more suitable than FLT PET/CT for examining recurrence of postoperative differentiated thyroid cancer.
Databáze: OpenAIRE
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