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 |
Externí odkaz: |