F-18-fluorodeoxyglucose positron emission tomography as a presurgical evaluation modality for I-131 scan-negative thyroid carcinoma patients with local recurrence in cervical lymph nodes.
BACKGROUND
F-18-labeled fluorodeoxyglucose-positron emission tomography (FDG-PET) has a supplementary role in localizing recurrent sites of differentiated thyroid carcinoma. We evaluated whether FDG-PET is feasible as a presurgical evaluation modality for I-131 scan-negative thyroid carcinoma patients.


METHODS
Preoperative FDG-PET results were compared with the pathologic findings of lymph nodes specimens of 22 papillary thyroid patients. All patients had thyroidectomy and I-131 ablation therapy beforehand and showed negative I-131 scans on follow-up studies.


RESULTS
In 85 cervical lymph node groups dissected, 56 lymph node groups revealed metastasis. The sensitivity and specificity of FDG PET for metastasis were 80% (45 of 56) and 83% (24 of 29), respectively. Among the pathologically positive 33 lymph nodes with normal size(< or =1 cm), FDG-PET detected 23 nodes. Serum thyroglobulin levels were elevated in 12 patients (sensitivity, 55%).


CONCLUSIONS
FDG-PET accurately detected the recurred cervical lymph nodes of differentiated thyroid carcinoma patients who showed negative I-131 scan. FDG-PET is suitable for the presurgical evaluation of these patients.
Yeo
J S
JS
Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Chongnogu, Korea.
Chung
J K
JK
So
Y
Y
Kim
S
S
Lee
E
E
Lee
D S
DS
Youn
Y K
YK
Hong
S J
SJ
Ahn
I M
IM
Lee
M C
MC
Cho
B Y
BY
D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007205:Indium Radioisotopes; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D011300:Preoperative Care; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy; D014055:Tomography, Emission-Computed
D007205:Indium Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18