TY - JOUR
T1 - FDG PET/CT in differentiated thyroid cancer patients with low thyroglobulin levels
AU - Lebbink, Chantal A.
AU - de Vries, Lisa H.
AU - Borel Rinkes, Inne H.M.
AU - Braat, Arthur J.A.T.
AU - van Leeuwaarde, Rachel S.
AU - Lodewijk, Lutske
AU - van Treijen, Mark J.C.
AU - Vriens, Menno R.
AU - Valk, Gerlof D.
AU - van Santen, Hanneke M.
AU - de Keizer, Bart
N1 - Publisher Copyright:
© 2022 European Society of Endocrinology.
PY - 2022/7
Y1 - 2022/7
N2 - 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 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.
AB - 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 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.
KW - Adenocarcinoma
KW - Fluorodeoxyglucose F18
KW - Humans
KW - Iodine Radioisotopes
KW - Neoplasm Recurrence, Local/pathology
KW - Positron Emission Tomography Computed Tomography
KW - Positron-Emission Tomography
KW - Retrospective Studies
KW - Thyroglobulin
KW - Thyroid Neoplasms/diagnostic imaging
UR - http://www.scopus.com/inward/record.url?scp=85130863284&partnerID=8YFLogxK
U2 - 10.1530/EJE-22-0072
DO - 10.1530/EJE-22-0072
M3 - Article
C2 - 35521710
SN - 0804-4643
VL - 187
SP - 101
EP - 110
JO - European Journal of Endocrinology
JF - European Journal of Endocrinology
IS - 1
ER -