FDG PET/CT in differentiated thyroid cancer patients with low thyroglobulin levels
Lebbink, Chantal A.; de Vries, Lisa H.; Borel Rinkes, Inne H.M.; Braat, Arthur J.A.T.; van Leeuwaarde, Rachel S.; Lodewijk, Lutske; van Treijen, Mark J.C.; Vriens, Menno R.; Valk, Gerlof D.; van Santen, Hanneke M.; de Keizer, Bart
(2022) European Journal of Endocrinology, volume 187, issue 1, pp. 101 - 110
(Article)
Abstract
Objective: To evaluate the usefulness of [18F]fluorodeoxyglucose (FDG) positron emissive tomography (PET)/CT in patients with low detectable thyroglobulin levels suspicious for persistent or recurrent differentiated thyroid cancer (DTC). Methods: A retrospective case series study evaluating FDG PET/CT in patients with detectable thyroglobulin (Tg) levels (≥0.20 and <10.00 ng/mL) after initial
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treatment with total thyroidectomy and I-131 thyroid remnant ablation for pT1-3aN0-1bM0 DTC. Sensitivity, specificity, positive (PPV) and negative predictive value (NPV) of FDG PET/CT were calculated. Results: Twenty-seven patients underwent FDG PET/CT. Median Tg level at FDG PET/CT was 2.00 ng/mL (range 0.30-9.00). FDG PET/CT was positive in 14 patients (51.9%): lesions suspicious for lymph node metastases were depicted in 12 patients, and lung metastases in 2. DTC was confirmed in 13/14 FDG PET/CT-positive patients. In 9/13 patients with a negative FDG PET/CT, DTC was confirmed ≤3 months after FDG PET/CT. The sensitivity, PPV, specificity and NPV were 59.1, 92.9, 80.0 and 30.8%, respectively. Conclusions: This case series shows that FDG PET/CT might be useful to detect persistent or recurrent DTC in patients with low detectable Tg. However, when FDG PET/CT is negative, this does not rule out DTC and further investigations are necessary.
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Keywords: Adenocarcinoma, Fluorodeoxyglucose F18, Humans, Iodine Radioisotopes, Neoplasm Recurrence, Local/pathology, Positron Emission Tomography Computed Tomography, Positron-Emission Tomography, Retrospective Studies, Thyroglobulin, Thyroid Neoplasms/diagnostic imaging, Endocrinology, Diabetes and Metabolism, Endocrinology, Journal Article
ISSN: 0804-4643
Publisher: BioScientifica Ltd.
Note: Publisher Copyright: © 2022 European Society of Endocrinology.
(Peer reviewed)