Medical Radiology and Radiation Safety. 2016. Vol. 61. No. 4. P. 59-63

NUCLEAR MEDICINE

T.M. Geliashvili, A.V. Vazhenin, E.B. Vasil’eva, N.G. Afanas’eva

Experience of Use ¹⁸F-FDG PET/CT in Detecting Tumor Recurrence and Metastasis of Differentiated Thyroid Cancer

Chelyabinsk Regional Clinical Oncology Center, Chelyabinsk, Russia, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

ABSTRACT

Purpose: To investigate the diagnostic accuracy and impact in patients management of the integrated ¹⁸F-FDG PET/CT modality in patients with differentiated thyroid cancer.

Material and methods: A retrospective review of patients who underwent PET/CT scans were performed. The study included patients with elevated thyroglobulin levels during the postoperative radioiodine ablation course or after completion of the combination treatment at follow-up of DTC.

Results: PET/CT was positive in 39 cases (64 %), 18 (46.1 %) of which was loco-regional recurrence, 12 (30.8 %) - distant metastases and the combination of loco-regional recurrence with distant metastases 9 (23.1 %). The negative result was obtained for 22 (36 %) PET/CT study (without pathology 7 (31.8 %), questionable results 15 (68.2 %)). Totally 27 (44.3 %) loco-regional recurrences diagnosed with PET / CT, and by 131I whole body scan (WBS) - 14 (23 %)). 15 surgical interventions for loco-regional recurrence were achieved. Diagnosis of recurrence in 13 cases (87 %) was proved historically. In 2 (13 %) patients we received a false-positive results of PET/CT. In 21 (34.4 %) of PET/CT study distant metastases were revealed (in the lungs and/or mediastinum - 14 (67 %), in bone 3 (14 %), a combination of several sites of distant metastases 4 (19 %)). In 11 of 14 cases (78.6 %) lung metastases were revealed exclusively in CT mode. Mediastinal lymph node metastases appeared all PET-positive 6 (100 %). Metastases in other organs were detected in 7 cases out of which all bone metastases were PET positive (6 cases); soft tissue metastases identified by CT mode in 1 case. By planar WBS detected distant metastases in 18 cases (29.5 %).

Conclusions: PET/CT showed higher sensitivity in the detection of the neck lymph nodes metastases (44.3 %) than WBS (23 %). With regard to detection of distant metastases, PET/CT and WBS showed similar sensitivity (34.5 % and 29.5 %, respectively). Through a combination of modes of PET with CT mode the sensitivity of PET/CT in detection of metastases in the lungs increases greatly.

Key words¹⁸: F-FDG PET/CT, differentiated thyroid cancer, whole body scan, loco-regional recurrence, distant metastases

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For citation: Geliashvili TM, Vazhenin AV, Vasil'eva EB, Afanas'eva NG. Experience of Use ¹⁸F-FDG PET/CT in Detecting Tumor Recurrence and Metastasis of Differentiated Thyroid Cancer. Medical Radiology and Radiation Safety. 2016;61(4):59-63. Russian.

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