title: Clinical value of [(18)F]FDG-PET/CT in the detection of metastatic medullary thyroid cancer.
abstract: OBJECTIVE
  To evaluate the value of fluorine-18 2-deoxy-2-d-glucose positron emission tomography/computed tomography ([(18)F]FDG-PET/CT) in the detection of metastatic medullary thyroid cancer.
  
  
  METHODS
  From November 2006 to November 2012, 50 medullary thyroid cancer patients (median age 48.7 years, range 18-76) who had a total thyroidectomy operation underwent whole-body [(18)F]FDG-PET/CT scans. The diagnostic accuracy of [(18)F]FDG-PET/CT was determined through both lesion-based and patient-based analyses. Further pathological tests were performed on all identified lesions or clinically followed for a minimum period of 6 months.
  
  
  RESULTS
  One hundred forty-four suspicious lesions were identified by organ-based analysis. Of these lesions, [(18)F]FDG-PET/CT detected 99 true-positive lesions, sensitivity was 73.3%, and specificity was 66.7%. On the patient-based analysis, the overall sensitivity and specificity were calculated as 65.7% and 92.3%, respectively. Using a cutoff calcitonin value of 1000 pg/ml, in patients with calcitonin lower than this value, sensitivity and specificity were 42.9% and 91.0%, respectively. In patients with calcitonin exceeding this value, they raised to 77.3% (χ(2)=4.392, P<.05) and 100% (χ(2)=0.197, P>.05), respectively. Compared with conventional imaging modality, PET/CT scans detected more lesions in 10 patients (20.4%) and correctly changed the treatment in 8 patients (16.3%).
  
  
  CONCLUSIONS
  [(18)F]FDG-PET/CT has excellent sensitivity and specificity, especially when the calcitonin value is higher than 1000 pg/ml for detecting metastatic medullary thyroid cancer. Compared to conventional morphologic imaging methods, it provides additional information for diagnosis.
authors: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors: Jinjin
authors: J
authors: Jiang
authors: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors: Zhongyi
authors: Z
authors: Yang
authors: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors: Yongping
authors: Y
authors: Zhang
authors: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors: Xiaoping
authors: X
authors: Xu
authors: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors: Mingwei
authors: M
authors: Wang
authors: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors: Silong
authors: S
authors: Hu
authors: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors: Zhifeng
authors: Z
authors: Yao
authors: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors: Herong
authors: H
authors: Pan
authors: Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors: Yingjian
authors: Y
authors: Zhang
authors: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China; Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China. Electronic address: proflids@163.com.
authors: Duanshu
authors: D
authors: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018278:Carcinoma, Neuroendocrine; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013961:Thyroid Gland / Q000000981:diagnostic imaging; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Calcitonin; Medullary thyroid carcinoma; Metastasis; PET/CT