Biomaterial Database

18F-FDG SPECT/CT in the diagnosis of differentiated thyroid carcinoma with elevated thyroglobulin and negative iodine-131 scans. 2015

C Ma, and X Wang, and M Shao, and L Zhao, and X Jiawei, and Z Wu, and H Wang

Department of Nuclear Medicine, Xinhua Hospital of Medical School, Shanghai Jiaotong University, Shanghai, Republic of China - wanghuishanghai@hotmail.com.

OBJECTIVE Aim of the present study was to investigate the usefulness of 18F-FDG SPECT/CT in differentiated thyroid cancer (DTC) with elevated serum thyroglobulin (Tg) but negative iodine-131 scan. METHODS This retrospective review of patients with DTC recurrence who had 18F-FDG SPECT/CT and 18F-FDG PET/CT for elevated serum Tg but negative iodine-131 scan (March 2007-October 2012). After total thyroidectomy followed by radioiodine ablation, 86 consecutive patients with elevated Tg levels underwent 18F-FDG SPECT/CT or 18F-FDG PET/CT. Of these, 45 patients had 18F-FDG SPECT/CT, the other 41 patients had 18F-FDG PET/CT 3-4weeks after thyroid hormone withdrawal. The results of 18F-FDG PET/CT and SPECT/CT were correlated with patient follow-up information, which included the results from subsequent imaging modalities such as neck ultrasound, MRI and CT, Tg levels, and histologic examination of surgical specimens. The diagnostic accuracy of the two imaging modalities was evaluated. RESULTS In 18F-FDG SPECT/CT scans, 24 (24/45) patients had positive findings, 22 true positive in 24 patients, false positive in 2 patients, true-negative and false-negative in 6, 15 patients, respectively. The overall sensitivity, specificity, and accuracy of 18F-FDG SPECT/CT were 59.5%, 75% and 62.2%, respectively. Twenty six patients had positive findings on 18F-FDG PET/CT scans, 23 true positive in 26 (26/41) patients, false positive in 3 patients, true-negative and false-negative in 9, 6 patients, respectively. The overall sensitivity, specificity, and accuracy of 18F-FDG PET/CT were 79.3%, 81.8% and 78.1%, respectively. Clinical management changed for 13 (29%) of 45 patients by 18F-FDG SPECT/CT, 14 (34%) of 41 patients by 18F-FDG PET/CT including surgery, radiation therapy, or multikinase inhibitor. CONCLUSIONS Based on the retrospective analysis of 86 patients, 18F-FDG SPECT/CT has lower sensitivity in the diagnosis of DTC recurrence with elevated Tg and negative iodine-131scan to 18F-FDG PET/CT. The clinical application of FDG SPECT/CT is then limited and cannot replace PET/CT.

UI	MeSH Term	Description	Entries
D007089	Image Enhancement	Improvement of the quality of a picture by various techniques, including computer processing, digital filtering, echocardiographic techniques, light and ultrastructural MICROSCOPY, fluorescence spectrometry and microscopy, scintigraphy, and in vitro image processing at the molecular level.	Image Quality Enhancement,Enhancement, Image,Enhancement, Image Quality,Enhancements, Image,Enhancements, Image Quality,Image Enhancements,Image Quality Enhancements,Quality Enhancement, Image,Quality Enhancements, Image
D007457	Iodine Radioisotopes	Unstable isotopes of iodine that decay or disintegrate emitting radiation. I atoms with atomic weights 117-139, except I 127, are radioactive iodine isotopes.	Radioisotopes, Iodine
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D005188	False Negative Reactions	Negative test results in subjects who possess the attribute for which the test is conducted. The labeling of diseased persons as healthy when screening in the detection of disease. (Last, A Dictionary of Epidemiology, 2d ed)	False Negative Reaction,Reaction, False Negative,Reactions, False Negative
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012680	Sensitivity and Specificity	Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed)	Specificity,Sensitivity,Specificity and Sensitivity
D013954	Thyroglobulin
D013964	Thyroid Neoplasms	Tumors or cancer of the THYROID GLAND.	Cancer of Thyroid,Thyroid Cancer,Cancer of the Thyroid,Neoplasms, Thyroid,Thyroid Adenoma,Thyroid Carcinoma,Adenoma, Thyroid,Adenomas, Thyroid,Cancer, Thyroid,Cancers, Thyroid,Carcinoma, Thyroid,Carcinomas, Thyroid,Neoplasm, Thyroid,Thyroid Adenomas,Thyroid Cancers,Thyroid Carcinomas,Thyroid Neoplasm