title: Imaging in endocrinology: 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography in differentiated thyroid carcinoma: clinical indications and controversies in diagnosis and follow-up.
abstract: In recent years, 2-[(18)F]-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) has emerged as an important tool for the postoperative management of patients with differentiated thyroid cancer (DTC) and it is widely used in selected clinical situations. The most valuable role that FDG-PET/CT plays in clinical practice is that it can be used to obtain prognostic information in patients with increasing thyroglobulin (Tg) levels and negative (131)I whole-body scan post-thyroidectomy and radioiodine (RAI) ablation. FDG-PET/CT may also have a potential role in the initial staging and follow-up of high-risk patients with aggressive histological subtypes, in the identification of patients who are at the highest risk of disease-specific mortality, in the management of patients with RAI-refractory disease, in clinical trials of novel targeted therapies in patients with advanced metastatic disease, and in the evaluation of thyroid nodules with indeterminate fine-needle aspiration for cytology. However, several controversies remain to be resolved, namely: the cutoff value of Tg in the selection of DTC patients for FDG-PET/CT, whether FDG-PET/CT scanning should be performed under thyrotropin stimulation or suppression, and the clinical significance of thyroid FDG-PET/CT incidentalomas. The aim of the present article is to provide an overview of the data about the molecular basis for, clinical indications of, and controversies related to the use of FDG-PET/CT in patients with DTC.
authors.affiliation: Institute of Nuclear MedicinePoliclinico Universitario 'A. Gemelli', Università Cattolica del Sacro Cuore, Roma, Largo Agostino Gemelli 8, 00168 Rome, ItalyDepartment of Clinical and Molecular Endocrinology and OncologyUniversity of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Salvatori
authors.affiliation: Institute of Nuclear MedicinePoliclinico Universitario 'A. Gemelli', Università Cattolica del Sacro Cuore, Roma, Largo Agostino Gemelli 8, 00168 Rome, ItalyDepartment of Clinical and Molecular Endocrinology and OncologyUniversity of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Biondi
authors.affiliation: Institute of Nuclear MedicinePoliclinico Universitario 'A. Gemelli', Università Cattolica del Sacro Cuore, Roma, Largo Agostino Gemelli 8, 00168 Rome, ItalyDepartment of Clinical and Molecular Endocrinology and OncologyUniversity of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy.
authors.forename: Vittoria
authors.initials: V
authors.lastname: Rufini
mesh_terms: D002277:Carcinoma / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006801:Humans; D007457:Iodine Radioisotopes / Q000378:metabolism / Q000627:therapeutic use; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals / Q000378:metabolism / Q000627:therapeutic use; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000628:therapy; D013965:Thyroidectomy; D014057:Tomography, X-Ray Computed; D051598:Whole Body Imaging
chemical_list: D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18