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Prospective evaluation of 68Ga-DOTANOC PET-CT in differentiated thyroid cancer patients with raised thyroglobulin and negative 131I-whole body scan: comparison with 18F-FDG PET-CT

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The purpose of the study was to evaluate the role of 68Ga-DOTANOC PET-CT in differentiated thyroid cancer (DTC) patients with negative 131I-whole body scan (WBS) along with serially increasing serum thyroglobulin (Tg), and compare the same with 18F-FDG PET-CT.

Methods

Sixty two DTC patients with serially rising Tg levels and negative 131I-WBS were prospectively enrolled. All patients underwent 68Ga-DOTANOC PET-CT and 18F-FDG PET-CT within an interval of two weeks. PET-CT analysis was done on a per-patient basis, location wise and lesion wise. All PET-CT lesions were divided into four categories-local, nodal, pulmonary and skeletal. Histopathology and/or serial serum Tg level, clinical and imaging follow up (minimum-1 year) were used as a reference standard.

Results

Ga-DOTANOC PET-CT demonstrated disease in 40/62 (65 %) patients and 18F-FDG PET-CT in 45/62 (72 %) patients, with no significant difference on McNemar analysis (p = 0.226). Per-patient sensitivity and specificity of 68Ga-DOTANOC PET-CT was 78.4 %, 100 %, and for 18F-FDG PET-CT was 86.3 %, 90.9 %, respectively. Out of 186 lesions detected by both PET-CTs, 121/186 (65 %) lesions were seen on 68Ga-DOTANOC PET-CT and 168/186 (90.3 %) lesions on 18F-FDG PET-CT (p < 0.0001). There were 103/186 (55 %) lesions concordant on both. Excellent agreement was noted between 68Ga-DOTANOC PET-CT and 18F-FDG PET-CT for detection of local disease (ĸ = 0.92), while moderate agreement was noted for nodal and pulmonary disease (ĸ = 0.67). 68Ga-DOTANOC PET-CT changed management in 21/62 (34 %) patients and 18F-FDG PET-CT in 17/62 (27 %) patients.

Conclusion

Ga-DOTANOC PET-CT is inferior to 18F-FDG PET-CT on lesion based but not on patient based analysis for detection of recurrent/residual disease in DTC patients with negative WBS scan and elevated serum Tg levels. It can also help in selection of potential candidates for peptide receptor radionuclide therapy.

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Conflict of interest

The authors declare that there is no conflict of interest.

No funding was received from any organization for this study.

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Authors and Affiliations

  1. Department of Nuclear Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India

    Parveen Kundu, Sneh Lata, Punit Sharma, Harmandeep Singh, Arun Malhotra & Chandrasekhar Bal

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  1. Parveen Kundu
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  2. Sneh Lata
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  3. Punit Sharma
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  4. Harmandeep Singh
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  6. Chandrasekhar Bal
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Correspondence to Chandrasekhar Bal.

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Kundu, P., Lata, S., Sharma, P. et al. Prospective evaluation of 68Ga-DOTANOC PET-CT in differentiated thyroid cancer patients with raised thyroglobulin and negative 131I-whole body scan: comparison with 18F-FDG PET-CT. Eur J Nucl Med Mol Imaging 41, 1354–1362 (2014). https://doi.org/10.1007/s00259-014-2723-9

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  • DOI: https://doi.org/10.1007/s00259-014-2723-9

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