18F-FDG PET in the management of patients with anaplastic thyroid carcinoma.
BACKGROUND
Anaplastic thyroid carcinoma (ATC) is one of the most aggressive solid tumors in humans. The use of positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) in ATC has not been studied, and only a few case reports have been published. The objective of this study was to investigate the potential contribution of 18F-FDG PET to the clinical management of patients with ATC.


METHODS
All patients with ATC studied with 18F-FDG PET from August 2001 through March 2007 were included. The PET results were correlated with computed tomography, ultrasound, magnetic resonance imaging, bone scan, histology, and clinical follow-up. The FDG uptake was semiquantified as maximum standard uptake value. Any change in the treatment plan as a direct result of the PET findings as documented in the clinical notes was recorded.


RESULTS
Sixteen patients were included. True-positive PET findings were seen for all primary tumors, in all nine patients with lymph node metastases, in five out of eight patients with lung metastases, and in two patients with distant metastases other than lung metastases. In 8 of the 16 patients, the medical records reported a direct impact of the PET findings on the clinical management.


CONCLUSIONS
ATC demonstrates intense uptake on 18F-FDG PET images. In 8 of the 16 patients (50%), the medical records reported a direct impact of the PET findings on the management of the patient. PET may improve disease detection and have an impact on the management of patients with ATC relative to other imaging modalities.
Bogsrud
Trond Velde
TV
Division of Nuclear Medicine, Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Karantanis
Dimitrios
D
Nathan
Mark A
MA
Mullan
Brian P
BP
Wiseman
Gregory A
GA
Kasperbauer
Jan L
JL
Reading
Carl C
CC
Hay
Ian D
ID
Lowe
Val J
VJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000175:diagnosis / Q000378:metabolism / Q000532:radiotherapy*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000532:radiotherapy*; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18