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18F-FDG PET/CT in Patients with Suspected Recurrent or Metastatic Well-Differentiated Thyroid Cancer

Amer Shammas1, Berna Degirmenci1,2, James M. Mountz1, Barry M. McCook1, Barton Branstetter1,3, Badreddine B. Bencherif1, Judith M. Joyce1, Sally E. Carty4, Haruko A. Kuffner5 and Norbert Avril1,6

1 Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; 2 Department of Nuclear Medicine, Dokuz, Eylul University Medical School, Izmir, Turkey; 3 Department of Endocrinology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; 4 Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; 5 Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; and 6 Department of Nuclear Medicine, Barts and the London School of Medicine, Queen Mary, University of London, London, United Kingdom


Figure 1
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  		FIGURE 1.  A 47-y-old woman with history of papillary thyroid cancer who underwent thyroidectomy and radioiodine ablation. Two years later, patient presented with thyroglobulin level of 6.1 ng/mL (TSH suppressed) and negative findings on 131I WBS. 18F-FDG PET (A) demonstrates small foci of increased 18F-FDG uptake (arrows) corresponding to small lymph nodes in right lower neck on CT (B). These are clearly visualized on fused 18F-FDG PET/CT (C) and were subsequently proven to be thyroid cancer metastases.

 

Figure 2
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  		FIGURE 2.  A 62-y-old man with history of papillary thyroid cancer. 131I WBS and 18F-FDG PET/CT were performed 1 y previously and had negative findings (thyroglobulin, 6.9 ng/mL). At current presentation, patient has thyroglobulin level of 29 ng/mL and small focal area of increased 18F-FDG uptake in left neck (arrow). Focus was proven by histopathology to be thyroid cancer metastasis. Shown are 18F-FDG PET (A), CT (B), and fused 18F-FDG PET/CT (C) images.

 




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