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General Clinical Specialties: General Practice-OncologyGeneral Practice-Oncology Posters |
1 Radiology/Nuclear Medicine; 2 Medicine/Endocrinology; 3 Medicine/Oncology, Walter Reed Army Medical Center, Washington, District of Columbia
1061
Objectives: To establish the advantages of stimulated rhTSH PET/CT compared to an I-WBS, a retrospective analysis was performed.
Methods: Records of patients undergoing a recombinant hormone TSH (rhTSH) stimulated PET/CT between March 2003 and May 2007 were reviewed and compared against findings on I-WBS as well as thyroglobulin, thyroglobulin antibody and available pathology results.
Results: Fifty-five rhTSH PET/CT scan results were reviewed. Fifty-two had I-WBS and 20 pathology reports for comparison. Of the 52 I-WBS, 44 were rhTSH stimulated. Twenty-two PET/CT scans were read as abnormal and discordant with I-WBS. Thirty-five I-WBS did not show abnormal iodine uptake. The average thyroglobulin level was 59.14 ng/ml (range <0.2 to 2121.9 ng/ml.) Of the 11 abnormal pathology results, there was 100% concordance with abnormal PET/CT findings but only 36% concordance on I-WBS. However, of 9 histological specimens interpreted as normal, PET/CT and I-WBS yielded 8 and 5 false-positive results, respectively. Of twelve PET/CT studies performed on patients with thyroglobulin antibodies, 8 had scan abnormalities whereas I-WBS had 4 of 12 positive scans with a concordance with PET/CT in 3 of the 8 cases. Pathology was available for 6 of these cases revealing a 50% concordance with positive PET/CT.
Conclusions: RhTSH PET/CT was found to be more sensitive than I-WBS but with similarly low specificity. PET/CT was particularly useful at detecting abnormalities in thyroglobulin antibody positive patients at 66.7% compared to 8% with I-WBS.
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