HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Related articles in JNM Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Palmedo, H. Articles by Jaeger, U. Search for Related Content PubMed PubMed Citation Articles by Palmedo, H. Articles by Jaeger, U.

Integrated PET/CT in Differentiated Thyroid Cancer: Diagnostic Accuracy and Impact on Patient Management

¹ Department of Nuclear Medicine, University Hospital of Bonn, Bonn, Germany; ² Department of Radiology, University Hospital of Bonn, Bonn, Germany; ³ Department of Surgery, University Hospital of Bonn, Bonn, Germany; and ⁴ Department of Pathology, University Hospital of Bonn, Bonn, Germany

Correspondence: For correspondence or reprints contact: Holger Palmedo, MD, Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany. E-mail: holger.palmedo{at}ukb.uni-bonn.de

The aim of this study was to investigate the diagnostic accuracy and impact on patient management of the new integrated PET/CT modality in patients with suspected iodine-negative, differentiated thyroid carcinoma (DTC). Methods: Forty patients with DTC and a suggestion of iodine-negative tumor tissue underwent PET/CT examination (370 MBq ¹⁸F-FDG, coregistered PET/CT whole-body images). As the first step of analysis, PET and CT images were scored blindly and independently by 2 nuclear medicine physicians and 2 radiologists. A 5-point scale was used. The second step consisted of a consensus reading, during which a virtual side-by-side fusion of PET and CT images was initially evaluated and afterward the "real" fusion (i.e., coregistered) PET/CT images were also scored with the same 5-point scale. The imaging results were compared with histopathologic findings and the course of disease during further follow-up examinations. Results: One hundred twenty-seven lesions in 40 patients were evaluated. Diagnostic accuracy was 93% and 78% for PET/CT and PET, respectively (P = 0.049, per-patient analysis). In 17 (74%) of 23 patients with suspicious ¹⁸F-FDG foci, integrated PET/CT added relevant information to the side-by-side interpretation of PET and CT images by precisely localizing the lesion(s). In tumor-positive PET patients, PET/CT fusion by coregistration led to a change of therapy in 10 (48%) patients. Futile surgery was prevented in an additional 3 patients. Conclusion: Integrated PET/CT is able to improve diagnostic accuracy in a therapeutically relevant way in patients with iodine-negative DTC. By precisely localizing tumor tissue, image fusion by integrated PET/CT is clearly superior to side-by-side interpretation of PET and CT images.

Key Words: integrated PET/CT • differentiated thyroid cancer • ¹⁸F-FDG PET • Hürthle cell tumor • iodine negative

Related articles in JNM:

This Month in JNM

JNM 2006 47: 9a-10a. [Full Text]  

This article has been cited by other articles:

				N. A. Johnson and M. E. Tublin Postoperative Surveillance of Differentiated Thyroid Carcinoma: Rationale, Techniques, and Controversies Radiology, November 1, 2008; 249(2): 429 - 444. [Abstract] [Full Text] [PDF]

				R. T. Kloos Approach to the Patient with a Positive Serum Thyroglobulin and a Negative Radioiodine Scan after Initial Therapy for Differentiated Thyroid Cancer J. Clin. Endocrinol. Metab., May 1, 2008; 93(5): 1519 - 1525. [Abstract] [Full Text] [PDF]

				S. E. Finkelstein, P. W. Grigsby, B. A. Siegel, F. Dehdashti, J. F. Moley, and B. L. Hall Combined [18F]Fluorodeoxyglucose Positron Emission Tomography and Computed Tomography (FDG-PET/CT) for Detection of Recurrent, 131I-Negative Thyroid Cancer Ann. Surg. Oncol., January 1, 2008; 15(1): 286 - 292. [Abstract] [Full Text] [PDF]

				D. J. A. Margolis, J. M. Hoffman, R. J. Herfkens, R. B. Jeffrey, A. Quon, and S. S. Gambhir Molecular Imaging Techniques in Body Imaging Radiology, November 1, 2007; 245(2): 333 - 356. [Abstract] [Full Text] [PDF]

				A. Shammas, B. Degirmenci, J. M. Mountz, B. M. McCook, B. Branstetter, B. B. Bencherif, J. M. Joyce, S. E. Carty, H. A. Kuffner, and N. Avril 18F-FDG PET/CT in Patients with Suspected Recurrent or Metastatic Well-Differentiated Thyroid Cancer J. Nucl. Med., February 1, 2007; 48(2): 221 - 226. [Abstract] [Full Text] [PDF]

				J. H. O, I. R. Yoo, S. H. Kim, H. S. Sohn, and S. K. Chung Clinical Significance of Small Pulmonary Nodules with Little or No 18F-FDG Uptake on PET/CT Images of Patients with Nonthoracic Malignancies J. Nucl. Med., January 1, 2007; 48(1): 15 - 21. [Abstract] [Full Text] [PDF]

				O. Israel and A. Kuten Early Detection of Cancer Recurrence: 18F-FDG PET/CT Can Make a Difference in Diagnosis and Patient Care J. Nucl. Med., January 1, 2007; 48(1_suppl): 28S - 35S. [Abstract] [Full Text] [PDF]

				J. Czernin, M. Allen-Auerbach, and H. R. Schelbert Improvements in Cancer Staging with PET/CT: Literature-Based Evidence as of September 2006 J. Nucl. Med., January 1, 2007; 48(1_suppl): 78S - 88S. [Abstract] [Full Text] [PDF]