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  • Title: 18F-FDG-PET/CT in Patients Affected by Differentiated Thyroid Carcinoma with Positive Thyroglobulin Level and Negative 131I Whole Body Scan. It's Value Confirmed by a Bicentric Experience.
    Author: Bertagna F, Albano D, Bosio G, Piccardo A, Dib B, Giubbini R.
    Journal: Curr Radiopharm; 2016; 9(3):228-234. PubMed ID: 27210819.
    Abstract:
    BACKGROUND: 18F-FDG-PET/CT applications in the field of differentiated thyroid cancer (DTC) are continuously growing. OBJECTIVE: To retrospectively analyze in a wide population enrolled in two nuclear medicine centers the diagnostic value of 18F-FDG-PET/CT in patients treated with 131I and negative 131I-WBS but in presence of Tg levels higher than 1ng/ml after TSH stimulation. METHOD: From September 2005 to December 2014, 154 patients affected by DTC, treated with 131I with negative 131I-WBS and Tg&amp≥1ng/ml underwent 18F-FDG-PET/CT. RESULTS: 66 patients (43%) had a negative 18F-FDG-PET/CT (mean Tg=7.7ng/ml; SD=9.6) and 88 (57%) a positive scan (mean Tg=169.4; SD=294.6) documenting bone, pulmonary, lymph-node metastases and local recurrences. There was no statistically significant correlation between 18F-FDGPET/ CT results and sex, previous lymphadenectomy, the "on-" or "off-therapy" state; on the contrary, there was a statistically significant correlation between PET results and primary tumor size (T1-T2 vs. T3-T4). ROC analysis showed that the highest accuracy in terms of best compromise between sensitivity and specificity (sensitivity= 71,6%; specificity=92,4%; AUC area under the curve= 0.807) is achieved when the 12ng/mL is considered the Tg cut-off value to interpret the results. CONCLUSION: Our study confirm in a wide population that 18F-FDG-PET/CT is useful in evaluating patients affected by DTC, negative 131I-WBS and Tg>1ng/ml, identifying 12ng/ml as the Tg level cut-off over which is better to perform the study.
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