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Clinical and pathological factors related to 18F-FDG-PET positivity in the diagnosis of recurrence and/or metastasis in patients with differentiated thyroid cancer
Annals of Surgical Oncology, 05/11/09

Esteva D et al. - ¹⁸F-FDG-PET study offers a high sensitivity and positive predictive value (PPV) in DTC patients with negative whole-body scan (WBS) and thyroglobulin (Tg) positive. The use of FDG-PET is strongly recommended in DTC patients with large tumors, thyroid capsule invasion or poor-prognosis variants.

Methods

Study was undertaken to:
- analyze the relationship between a positive ¹⁸F- FDG-PET result and clinical and tumor factors in pts treated for differentiated thyroid cancer (DTC) and under suspicion of recurrence or metastasis, and
- determine the diagnostic validity of PET in DTC pts with elevated serum Tg and negative ¹³¹I WBS
50 DTC pts with elevated serum Tg and negative WBS treated with total thyroidectomy and ¹³¹I ablation
Thyroxin treatment was withdrawn and pts were on iodine-free diet before WBS
Tg, anti-Tg Abs, and TSH were determined
Pts with negative WBS and elevated Tg underwent PET study 1 week later
PET findings were verified by pathology findings or other imaging techniques and/or 12-mo f/u
Relationship between PET findings and tumor and clinical variables was analyzed

Results

PET was positive in 32/39 pts with confirmed disease and negative in 7/11 of disease-free cases a PPV of 89%
Tumor size and thyroid capsular invasion were associated with positive PET study
Relationship of PET findings with Tg levels and age at diagnosis was close to significance

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