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