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Journal of Nuclear Medicine

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OtherCLINICAL INVESTIGATIONS

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

Beate Schlüter, Karl H. Bohuslavizki, Wolfgang Beyer, Mykaylo Plotkin, Ralph Buchert and Malte Clausen
Journal of Nuclear Medicine January 2001, 42 (1) 71-76;
Beate Schlüter
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Karl H. Bohuslavizki
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Wolfgang Beyer
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Mykaylo Plotkin
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Ralph Buchert
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Malte Clausen
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  • FIGURE 1.
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    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.

  • FIGURE 2.
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    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.

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    TABLE 1.

    Validation of FDG PET Findings by Various Methods Applied

    FDG PETnValidation
    HistologyPositive 131ICT or MRIhTg follow-upCytology
    True-positive34178900
    False-positive720221
    True-negative500050
    False-negative15211110
    • n = number of patients.

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    TABLE 2.

    Treatment Strategy Drawn from Results of FDG PET

    FDG PETnTreatment
    Surgery131I therapyExternal irradiationNCTONTN
    True-positive*341810470
    False-positive720005
    True-negative500005
    False-negative15310110
    • ↵* Figures in first line exceed number of patients because some patients got more than one treatment (e.g., surgery and external irradiation).

    • n = number of patients; NCTO = no curative treatment option available because of widespread disease; NTN = no treatment necessary.

    • View popup
    TABLE 3.

    True-Positive FDG PET Findings with Respect to hTg Level

    hTg (μg/L)TSH (μIU/mL)Σ
    >30≤0.1
    <102/120/72/19
    10≤203/61/24/8
    20≤506/82/28/10
    50≤1004/71/15/8
    >1009/105/514/15
    • One patient could not be considered because his hTg level was unknown.

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Journal of Nuclear Medicine
Vol. 42, Issue 1
January 1, 2001
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Impact of FDG PET on Patients with Differentiated Thyroid Cancer Who Present with Elevated Thyroglobulin and Negative 131I Scan
Beate Schlüter, Karl H. Bohuslavizki, Wolfgang Beyer, Mykaylo Plotkin, Ralph Buchert, Malte Clausen
Journal of Nuclear Medicine Jan 2001, 42 (1) 71-76;

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Impact of FDG PET on Patients with Differentiated Thyroid Cancer Who Present with Elevated Thyroglobulin and Negative 131I Scan
Beate Schlüter, Karl H. Bohuslavizki, Wolfgang Beyer, Mykaylo Plotkin, Ralph Buchert, Malte Clausen
Journal of Nuclear Medicine Jan 2001, 42 (1) 71-76;
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  • Clinical Usefulness of FDG PET in Differentiated Thyroid Cancer
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Cited By...

  • ENDOCRINE TUMOURS: Imaging in the follow-up of differentiated thyroid cancer: current evidence and future perspectives for a risk-adapted approach
  • NCCN Task Force: Clinical Utility of PET in a Variety of Tumor Types
  • PET/CT fusion technology: its role in managing recurrent, well-differentiated thyroid cancer
  • Comparison of 18F-FDG PET and Bone Scintigraphy in Detection of Bone Metastases of Thyroid Cancer
  • 18F-FDG PET/CT in Patients with Suspected Recurrent or Metastatic Well-Differentiated Thyroid Cancer
  • The contribution of PET/CT to improved patient management
  • Possible Explanations for Patients with Discordant Findings of Serum Thyroglobulin and 131I Whole-Body Scanning
  • Empirically Treating High Serum Thyroglobulin Levels
  • Progress and Promise of FDG-PET Imaging for Cancer Patient Management and Oncologic Drug Development
  • PET in the follow-up of differentiated thyroid cancer
  • Clinical Usefulness of FDG PET in Differentiated Thyroid Cancer
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More in this TOC Section

  • Feasibility of Ultra-Low-Activity 18F-FDG PET/CT Imaging Using a Long–Axial-Field-of-View PET/CT System
  • Cardiac Presynaptic Sympathetic Nervous Function Evaluated by Cardiac PET in Patients with Chronotropic Incompetence Without Heart Failure
  • Validation and Evaluation of a Vendor-Provided Head Motion Correction Algorithm on the uMI Panorama PET/CT System
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