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Impact of FDG PET on Patients with Differentiated Thyroid Cancer Who Present with Elevated Thyroglobulin and Negative ¹³¹I Scan

Department of Nuclear Medicine, University Hospital Eppendorf, Hamburg, Germany

View larger version (51K): [in a new window]   FIGURE 1. FDG-positive local recurrence (arrow) in 49-y-old man who presented with negative 131I scan after thyroidectomy and two courses of radioiodine treatment of papillary thyroid cancer initially staged as pT2bN0M0 (A). No tumor remnants were seen after further surgery (B) and during follow-up (C). Consequently, hTg levels dropped from 30 µg/L (preoperative) to 5 µg/L (postoperative) and 11 µg/L (follow-up). Images show maximum-intensity projections in anterior views.

View larger version (50K): [in a new window]   FIGURE 2. FDG-positive residual tumor and lymph node metastasis (arrows) in 57-y-old woman who presented after incomplete thyroidectomy and tumor resection of papillary thyroid cancer initially staged as pT4bN1Mx (A). FDG PET was performed to assess tumor extension and possible metastases before further surgery. Residual tumor masses were seen after additional surgery (B), and external irradiation yielded good response (C). After irradiation, hTg levels dropped from 24 to 1.5 µg/L. Images show maximum-intensity projections in anterior views.