title: Comparison of FDG-PET and technetium-99m MIBI SPECT to detect metastatic cervical lymph nodes in well-differentiated thyroid carcinoma with elevated serum HTG but negative I-131 whole body scan.
abstract: The aim of this study was to evaluate the usefulness of 18-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) and technetium-99m methoxyisobutylisonitrile (Tc-99m MIBI) single photon emission computed tomography (SPECT) in detecting metastatic cervical lymph nodes (LN) in well-differentiated thyroid carcinoma (DTC) after total thyroidectomy and radioiodine-131 (I-131) treatments in patients with elevated serum human thyroglobulin (hTg) levels but negative I-131 whole body scan (WBS). Fifteen DTC patients underwent nearly total thyroidectomy and I-131 treatments with cervical LN metastases were included in this study. All subjects had negative I-131 WBS and elevated hTg levels (hTg > or = 10 microIU/ml) under thyroid-stimulating hormone (TSH) stimulation (TSH > or = 30 microIU/ml). FDG-PET could detect all of the 15 (100%) patients with metastatic cervical LN, but Tc-99m MIBI SPECT revealed lesions in only 9 out of 15 (60%) patients (p value < 0.05). This study demonstrated that FDG-PET is more sensitive than Tc-99m MIBI SPECT in detecting metastatic cervical LN in DTC with elevated serum hTg levels but negative I-131 WBS.
authors.affiliation: Department of Surgery, Show Chwan Memorial Hospital, Changhua, Taiwan.
authors.forename: Hurng-Sheng
authors.initials: HS
authors.lastname: Wu
authors.forename: Wen-Sheng
authors.initials: WS
authors.lastname: Huang
authors.forename: Yao-Chi
authors.initials: YC
authors.lastname: Liu
authors.forename: Ruoh-Fang
authors.initials: RF
authors.lastname: Yen
authors.forename: Yeh-You
authors.initials: YY
authors.lastname: Shen
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D013954:Thyroglobulin / Q000097:blood*; D013964:Thyroid Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000532:radiotherapy / Q000601:surgery; D014055:Tomography, Emission-Computed / Q000379:methods; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D014915:Whole-Body Counting / Q000379:methods
chemical_list: D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D013954:Thyroglobulin; D017256:Technetium Tc 99m Sestamibi