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  • Title: Clinical value of [(18)F]FDG-PET/CT in the detection of metastatic medullary thyroid cancer.
    Author: Jiang J, Yang Z, Zhang Y, Xu X, Wang M, Hu S, Yao Z, Pan H, Zhang Y, Li D.
    Journal: Clin Imaging; 2014; 38(6):797-801. PubMed ID: 24973077.
    Abstract:
    PURPOSE: To evaluate the value of fluorine-18 2-deoxy-2-d-glucose positron emission tomography/computed tomography ([(18)F]FDG-PET/CT) in the detection of metastatic medullary thyroid cancer. METHODS: From November 2006 to November 2012, 50 medullary thyroid cancer patients (median age 48.7 years, range 18-76) who had a total thyroidectomy operation underwent whole-body [(18)F]FDG-PET/CT scans. The diagnostic accuracy of [(18)F]FDG-PET/CT was determined through both lesion-based and patient-based analyses. Further pathological tests were performed on all identified lesions or clinically followed for a minimum period of 6 months. RESULTS: One hundred forty-four suspicious lesions were identified by organ-based analysis. Of these lesions, [(18)F]FDG-PET/CT detected 99 true-positive lesions, sensitivity was 73.3%, and specificity was 66.7%. On the patient-based analysis, the overall sensitivity and specificity were calculated as 65.7% and 92.3%, respectively. Using a cutoff calcitonin value of 1000 pg/ml, in patients with calcitonin lower than this value, sensitivity and specificity were 42.9% and 91.0%, respectively. In patients with calcitonin exceeding this value, they raised to 77.3% (χ(2)=4.392, P<.05) and 100% (χ(2)=0.197, P>.05), respectively. Compared with conventional imaging modality, PET/CT scans detected more lesions in 10 patients (20.4%) and correctly changed the treatment in 8 patients (16.3%). CONCLUSION: [(18)F]FDG-PET/CT has excellent sensitivity and specificity, especially when the calcitonin value is higher than 1000 pg/ml for detecting metastatic medullary thyroid cancer. Compared to conventional morphologic imaging methods, it provides additional information for diagnosis.
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