title: Dual-modality FDG-PET/CT in follow-up of patients with recurrent iodine-negative differentiated thyroid cancer.
abstract: The usefulness of combined 2-[18F] fluoro-2-deoxy-D: -glucose positron emission tomography and computed tomography (FDG-PET/CT) in locating suspected recurrence in patients with iodine-negative differentiated thyroid cancer (DTC) was evaluated. Thirty-six patients with DTC and suspected iodine-negative recurrence underwent restaging with FDG-PET/CT. The images of CT, FDG-PET, both modalities viewed side by side (CT+PET), and FDG-PET/CT were evaluated by two physicians separately. Imaging results were correlated with either histology (n = 20) and/or clinical follow-up of at least 36 months. Recurrent disease was diagnosed in 22/36 patients. FDG-PET alone, CT alone, CT+PET, and FDG-PET/CT showed a sensitivity of 82%, 73%, 91%, and 96%, respectively. Specificities were 79%, 71%, 79%, and 100%, respectively. FDG-PET/CT significantly improved specificity compared with CT+PET and resulted in a further treatment modification in 5/36 patients (14%). CT alone was especially sensitive for lung metastases, FDG-PET alone for the remainder of the body. Accurate fusion of functional and morphologic data by FDG-PET/CT improves the staging accuracy of patients with suspected recurrence of iodine-negative DTC. This has an impact on patient management in a substantial number of patients.
authors.affiliation: Department of Nuclear Medicine, University of Duisburg/Essen, Hufelandstrasse 55, 45122, Essen, Germany. lutz.freudenberg@uni-duisburg-essen.de
authors.forename: Lutz S
authors.initials: LS
authors.lastname: Freudenberg
authors.forename: Andrea
authors.initials: A
authors.lastname: Frilling
authors.forename: Hilmar
authors.initials: H
authors.lastname: Kühl
authors.forename: Stefan P
authors.initials: SP
authors.lastname: Müller
authors.forename: Walter
authors.initials: W
authors.lastname: Jentzen
authors.forename: Andreas
authors.initials: A
authors.lastname: Bockisch
authors.forename: Gerald
authors.initials: G
authors.lastname: Antoch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000473:pathology; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011859:Radiography; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18