PT  - JOURNAL ARTICLE
AU  - Palmedo, Holger
AU  - Bucerius, Jan
AU  - Joe, Alexius
AU  - Strunk, Holger
AU  - Hortling, Niclas
AU  - Meyka, Susanne
AU  - Roedel, Roland
AU  - Wolff, Martin
AU  - Wardelmann, Eva
AU  - Biersack, Hans-Juergen
AU  - Jaeger, Ursula
TI  - Integrated PET/CT in Differentiated Thyroid Cancer: Diagnostic Accuracy and Impact on Patient Management
DP  - 2006 Apr 01
TA  - Journal of Nuclear Medicine
PG  - 616--624
VI  - 47
IP  - 4
4099  - http://jnm.snmjournals.org/content/47/4/616.short
4100  - http://jnm.snmjournals.org/content/47/4/616.full
SO  - J Nucl Med2006 Apr 01; 47
AB  - 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.