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Head Neck. 2018 Jan;40(1):94-102. doi: 10.1002/hed.24967. Epub 2017 Nov 11.

Prognostic implication of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography in patients with recurrent papillary thyroid cancer.

Author information

1
Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University School of Medicine, Pusan National University, Busan, South Korea.
2
Department of Nuclear Medicine, Pusan National University School of Medicine, Pusan National University, Busan, South Korea.
3
Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University, Busan, South Korea.
4
Department of Radiology, Pusan National University School of Medicine, Pusan National University, Busan, South Korea.
5
Department of Otorhinolaryngology-Head and Neck Surgery, Inje University Ilsan Paik Hospital, Ilsan, South Korea.

Abstract

BACKGROUND:

Fluorine-18 fluorodeoxyglucose positron emission tomography/CT (18 F-FDG PET/CT) has been widely accepted as an effective method for detecting recurrent papillary thyroid cancer (PTC) in patients with increased serum thyroglobulin (Tg) or Tg antibody (TgAb) levels and negative whole-body scintigraphy (WBS) results. The role of WBS as a diagnostic tool in detecting recurrence has relatively decreased recently. However, only a few studies have examined the usefulness of 18 F-FDG PET/CT for evaluating patients with recurrent PTC, regardless of the WBS results. The purpose of this analysis was to evaluate the diagnostic value and prognostic role of 18 F-FDG PET/CT for patients with recurrent PTC, irrespective of their WBS results.

METHODS:

Sixty-six patients with locoregional recurrent PTC who underwent 18 F-FDG PET/CT and neck CT within 6 months before surgical treatment were included in this retrospective analysis. Imaging findings were compared with postoperative histopathologic results. The diagnostic values of 18 F-FDG PET/CT and neck CT were compared according to the serum Tg and TgAb levels and cervical levels. Each patient's status at the last follow-up was also reviewed, and survival probabilities were estimated using the Kaplan-Meier plot.

RESULTS:

The sensitivity, specificity, and diagnostic accuracy of 18 F-FDG PET/CT for the entire patient group were 38.5%, 90.2%, and 58.3%, respectively. The corresponding neck CT values were 55.0%, 85.7%, and 66.7%, respectively. According to the serum Tg and TgAb levels, except for the specificity, most diagnostic values of 18 F-FDG PET/CT were worse than those of the neck CTs, with or without statistical significance. For the high maximum standardized uptake value (SUVmax) group (SUVmax >10) and the low SUVmax group, the median locoregional disease-free survival times were 33.3 months and 81.8 months, respectively (P < .001).

CONCLUSION:

The diagnostic value of 18 F-FDG PET/CT for localizing recurrent lesions was worse than that of the neck CT, irrespective of the WBS results. However, patients with a higher SUVmax showed a significantly worse prognosis than did those with a lower SUVmax. Therefore, we suggest that, in patients with recurrent PTC, 18 F-FDG PET/CT should be considered for prognostication rather than diagnosis.

KEYWORDS:

maximum standardized uptake value (SUVmax); positron emission tomography (PET)/CT; prognosis; recurrent thyroid cancer; serum thyroglobulin (Tg); thyroglobulin antibody (TgAb)

PMID:
29130586
DOI:
10.1002/hed.24967
[Indexed for MEDLINE]

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