Factors Associated with Positive F-18 Flurodeoxyglucose Positron Emission Tomography Before Thyroidectomy in Patients with Papillary Thyroid Carcinoma

Thyroid, 05/09/2012

Kim BS et al. – Pre-thyroidectomy (pre-Tx) F-18 flurodeoxyglucose (FDG) positron emission tomography (PET) is not recommended for routine use in patients with papillary thyroid carcinoma (PTC).

Methods

  • Patients were selected for a retrospective review of their records if they had a total Tx with central lymph node dissection for PTC and pre-Tx FDG PET-CT and US between 2006 and 2009.
  • Sixty patients who met these criteria were studied.
  • Patients who had a history of head and neck irradiation, surgery, or sclerotherapy with ethanol in the last 3 months were excluded.
  • The clinicopathologic factors-age, sex, size, tumor-node-metastasis (TNM) staging, the presence of extrathyroidal extention, multifocality, cervical lymph node metastases (CLNM), Hashimoto thyroiditis, and US characteristics-were evaluated to determine whether they were associated with positive pre-Tx FDG uptake.

Results

  • Forty-three (71.6%) of patients in the study had positive FDG uptake.
  • Larger tumors and the presence of CLNM were associated with a greater likelihood of positive FDG uptake.
  • The sensitivity, specificity, positive predictive value, and negative predictive value for CLNM detection by FDG PET-CT showed low statistical values.
  • When considering the excellence of US for evaluating a thyroid nodule size and the presence of CLNM, the clinical value of pre-Tx FDG PET-CT is comparatively limited.

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