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J Nucl Med. 2008; 49 (Supplement 1):7P
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General Clinical Specialties: Endocrinology

Management of Thyroid Cancer - What's New?

Value and clinical impact of 18FDG-PET/CT after rhTSH in the diagnosis of thyroid cancer recurrence with negative iodine scan

Antony Kelly1, Catherine Dejax1, Charles Merlin1, Danielle Mestas1, Bernadette Aubert1, David De Freitas1, Florent Cachin1 and Jean Maublant1

1 Nuclear Medicine, Jean Perrin Cancer Center, Clermont-Ferrand, France

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Objectives: To evaluate the interest of 18FDG-PET/CT after rhTSH in the suspicion of differentiated thyroid cancer recurrence with detectable thyroglubulin (Tg) and negative iodine whole body scan.

Methods: A series of 24 patients with detectable Tg and negative iodine whole body scan who had undergone FDG-PET/CT after exogenous stimulation from march 2004 has been retrospectively assessed. Tg measurements the day of the PET/CT (n=19/24), thyroglobulin measurements with suppressed TSH performed in the previous six months when available (n=15/24), pathologic results and follow up data have been analysed.

Results: The mean±sd stimulated thyroglobulin value was 32.7±58.6µg/l. Out of the 24 PET/CT, 10 showed pathological focal uptakes. Stimulated Tg and Tg with suppressed TSH values were higher for patients with pathological PET/CT (53.6±71ng/ml and 15.9±14.5ng/ml) than for patients with negative PET/CT(4.1±3.2ng/ml and 0.9±0.5ng/ml) (p<0.05). PET/CT was always positive when stimulated Tg>10ng/ml and always negative when <10ng/ml. PET/CT was always positive when Tg with suppressed TSH>2ng/ml and always negative when <2ng/ml. The management initially planned for the 10 patients with positive PET/CT was follow up without treatment and became surgery for 6 patients, radiotherapy for 2 patient and follow up without treatment for 2 patients. The recurrence has been confirmed for each patient surgically explored.

Conclusions: In this short series, FDG-PET/CT after rhTSH is an accurate imaging tool for the diagnosis of thyroid cancer recurrence with a sensitivity of 100% when Tg>10ng/ml after rhTSH or >2ng/ml with suppressed TSH. Intermodality changes of patient management induced by PET/CT were observed for 8/24 (33%) patients.





This Article
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Kelly, A.
Right arrow Articles by Maublant, J.
PubMed
Right arrow Articles by Kelly, A.
Right arrow Articles by Maublant, J.