Thyroid-stimulating hormone-stimulated fused positron emission tomography/computed tomography in the evaluation of recurrence in 131I-negative papillary thyroid carcinoma

Fluorine-18 2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) detects recurrence of papillary thyroid carcinoma (PTC) in thyroidectomized patients with elevated thyroglobulin (Tg) levels and negative (131)I-whole-body scans. This paper describes the utility of thyroid-stimulating hor...

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Published inThyroid (New York, N.Y.) Vol. 16; no. 3; p. 267
Main Authors Saab, George, Driedger, Albert A, Pavlosky, William, McDonald, Tom, Wong, Ching-Yee O, Yoo, John, Urbain, Jean-Luc
Format Journal Article
LanguageEnglish
Published United States 01.03.2006
Subjects
Adult
Carcinoma, Papillary - diagnostic imaging
Carcinoma, Papillary - pathology
False Negative Reactions
Female
Fluorodeoxyglucose F18
Humans
Iodine Radioisotopes
Male
Middle Aged
Neoplasm Recurrence, Local - diagnostic imaging
Positron-Emission Tomography
Thyroglobulin - blood
Thyroid Neoplasms - diagnostic imaging
Thyroid Neoplasms - pathology
Thyrotropin
Tomography, Emission-Computed
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Summary:Fluorine-18 2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) detects recurrence of papillary thyroid carcinoma (PTC) in thyroidectomized patients with elevated thyroglobulin (Tg) levels and negative (131)I-whole-body scans. This paper describes the utility of thyroid-stimulating hormone (TSH)-stimulated fused FDG-PET/computed tomography (CT) scanning on our first 15 patients of this population. Patients were prepared for PET/CT imaging with thyroid hormone withdrawal (n = 7) or recombinant human TSH (n = 8). All other imaging before the PET/CT did not demonstrate evidence of recurrence. PET/CT scans revealed active foci in 9 patients, 4 prepared with hypothyroidism, and 5 with exogenous TSH. Positive results were demonstrated even in those with relatively low stimulated-TSH Tg values (13 and 14 microg/L). Six patients with positive PET/CT scans were treated surgically, yielding malignant tissue for 5 of those patients. PET/CT scans performed under TSH stimulation are an effective method of detecting of recurrence of PTC and direct surgical interventions, even in those with persistently elevated but relatively low Tg levels.
ISSN:1050-7256
DOI:10.1089/thy.2006.16.267