Raef R Boktor, Sze Ting Lee, Salvatore U Berlangieri, Andrew M Scott
{"title":"18F-FDG PET/CT对分化型甲状腺癌患者治疗、131I全身扫描阴性及血清甲状腺球蛋白升高的影响","authors":"Raef R Boktor, Sze Ting Lee, Salvatore U Berlangieri, Andrew M Scott","doi":"10.22038/AOJNMB.2021.58276.1406","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong><sup>18</sup>F-FDG PET/CT is increasingly performed in patients with differen-tiated thyroid cancer. The aim of this study was to assess the clinical impact of <sup>18</sup>F-FDG PET/CT on the management of patients with differentiated thyroid carcinoma who had elevated serum thyroglobulin (Tg) and negative <sup>131</sup>I whole body scan (WBS).</p><p><strong>Methods: </strong>67 patients with differentiated thyroid carcinoma were included in this study. The findings of <sup>18</sup>F-FDG PET/CT imaging were compared with histo-pathology, follow up imaging, or clinical follow-up results. The diagnostic accuracy of <sup>18</sup>F-FDG PET/CT was evaluated for the entire patient group and for those patients with stimulated serum thyroglobulin levels of less than 5, 5-10, and more than 10 pmol/L as well as for local recurrences and metastases sites. The impact of <sup>18</sup>F-FDG PET/CT on therapeutic management was also evaluated.</p><p><strong>Results: </strong>30/67 patients had positive findings on <sup>18</sup>F-FDG PET/CT; 28 were true-positive and 2 were false-positive. <sup>18</sup>F-FDG PET/CT results were true-negative in 36 patients and false-negative in 1 patient. The overall sensitivity, specificity, accuracy, PPV and NPV of <sup>18</sup>F-FDG PET/CT were, 96.5%, 94.5%, 95.5%, 93.3%, and 97.2% respectively. Positive <sup>18</sup>F-FDG PET/CT findings were directly correlated with stimulated serum thyroglobulin levels, 7.1% had Tg between 5-10, and 92.9% had Tg greater than 10 pmol/L. <sup>18</sup>F-FDG PET/CT had a high or moderate impact on treatment management in 28 (41.8%) of patients.</p><p><strong>Conclusion: </strong><sup>18</sup>F-FDG PET/CT is able to improve diagnostic accuracy and have management impact in a therapeutically relevant way in patients with differentiated thyroid carcinoma who present with rising thyroglobulin level, negative <sup>131</sup>I WBS, and clinical suspicion of recurrent disease.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8742852/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of <sup>18</sup>F-FDG PET/CT on treatment of patients with differentiated thyroid carcinoma, negative <sup>131</sup>I whole body scan and elevated serum thyroglobulin.\",\"authors\":\"Raef R Boktor, Sze Ting Lee, Salvatore U Berlangieri, Andrew M Scott\",\"doi\":\"10.22038/AOJNMB.2021.58276.1406\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong><sup>18</sup>F-FDG PET/CT is increasingly performed in patients with differen-tiated thyroid cancer. The aim of this study was to assess the clinical impact of <sup>18</sup>F-FDG PET/CT on the management of patients with differentiated thyroid carcinoma who had elevated serum thyroglobulin (Tg) and negative <sup>131</sup>I whole body scan (WBS).</p><p><strong>Methods: </strong>67 patients with differentiated thyroid carcinoma were included in this study. The findings of <sup>18</sup>F-FDG PET/CT imaging were compared with histo-pathology, follow up imaging, or clinical follow-up results. The diagnostic accuracy of <sup>18</sup>F-FDG PET/CT was evaluated for the entire patient group and for those patients with stimulated serum thyroglobulin levels of less than 5, 5-10, and more than 10 pmol/L as well as for local recurrences and metastases sites. The impact of <sup>18</sup>F-FDG PET/CT on therapeutic management was also evaluated.</p><p><strong>Results: </strong>30/67 patients had positive findings on <sup>18</sup>F-FDG PET/CT; 28 were true-positive and 2 were false-positive. <sup>18</sup>F-FDG PET/CT results were true-negative in 36 patients and false-negative in 1 patient. The overall sensitivity, specificity, accuracy, PPV and NPV of <sup>18</sup>F-FDG PET/CT were, 96.5%, 94.5%, 95.5%, 93.3%, and 97.2% respectively. Positive <sup>18</sup>F-FDG PET/CT findings were directly correlated with stimulated serum thyroglobulin levels, 7.1% had Tg between 5-10, and 92.9% had Tg greater than 10 pmol/L. <sup>18</sup>F-FDG PET/CT had a high or moderate impact on treatment management in 28 (41.8%) of patients.</p><p><strong>Conclusion: </strong><sup>18</sup>F-FDG PET/CT is able to improve diagnostic accuracy and have management impact in a therapeutically relevant way in patients with differentiated thyroid carcinoma who present with rising thyroglobulin level, negative <sup>131</sup>I WBS, and clinical suspicion of recurrent disease.</p>\",\"PeriodicalId\":8503,\"journal\":{\"name\":\"Asia Oceania Journal of Nuclear Medicine and Biology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8742852/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Asia Oceania Journal of Nuclear Medicine and Biology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.22038/AOJNMB.2021.58276.1406\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asia Oceania Journal of Nuclear Medicine and Biology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.22038/AOJNMB.2021.58276.1406","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
Impact of 18F-FDG PET/CT on treatment of patients with differentiated thyroid carcinoma, negative 131I whole body scan and elevated serum thyroglobulin.
Objectives: 18F-FDG PET/CT is increasingly performed in patients with differen-tiated thyroid cancer. The aim of this study was to assess the clinical impact of 18F-FDG PET/CT on the management of patients with differentiated thyroid carcinoma who had elevated serum thyroglobulin (Tg) and negative 131I whole body scan (WBS).
Methods: 67 patients with differentiated thyroid carcinoma were included in this study. The findings of 18F-FDG PET/CT imaging were compared with histo-pathology, follow up imaging, or clinical follow-up results. The diagnostic accuracy of 18F-FDG PET/CT was evaluated for the entire patient group and for those patients with stimulated serum thyroglobulin levels of less than 5, 5-10, and more than 10 pmol/L as well as for local recurrences and metastases sites. The impact of 18F-FDG PET/CT on therapeutic management was also evaluated.
Results: 30/67 patients had positive findings on 18F-FDG PET/CT; 28 were true-positive and 2 were false-positive. 18F-FDG PET/CT results were true-negative in 36 patients and false-negative in 1 patient. The overall sensitivity, specificity, accuracy, PPV and NPV of 18F-FDG PET/CT were, 96.5%, 94.5%, 95.5%, 93.3%, and 97.2% respectively. Positive 18F-FDG PET/CT findings were directly correlated with stimulated serum thyroglobulin levels, 7.1% had Tg between 5-10, and 92.9% had Tg greater than 10 pmol/L. 18F-FDG PET/CT had a high or moderate impact on treatment management in 28 (41.8%) of patients.
Conclusion: 18F-FDG PET/CT is able to improve diagnostic accuracy and have management impact in a therapeutically relevant way in patients with differentiated thyroid carcinoma who present with rising thyroglobulin level, negative 131I WBS, and clinical suspicion of recurrent disease.