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The role of early 18F-FDG PET/CT in therapeutic management and ongoing risk stratification of high/intermediate-risk thyroid carcinoma

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Abstract

Little is known about the role in ongoing risk stratification of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) performed early after radioactive iodine (RAI) ablation in differentiated thyroid carcinoma (DTC). The aim of the study is to investigate whether 18F-FDG PET/CT performed early after RAI ablation is useful to detect disease and to influence therapy and ongoing risk stratification. Patients with high/intermediate risk of recurrent DTC were included. 18F-FDG PET/CT scan was performed within 6 months after RAI ablation. We confirmed results with other imaging techniques, pathology reports, or follow-up. We classified the patient response as excellent, acceptable, or incomplete. Modified Hicks criteria were used to evaluate clinical impact. We included 81 patients with high/intermediate risk of recurrent DTC. Forty-one (50.6 %) had positive uptake in 18F-FDG PET/CT, with negative 131I whole-body scan (131I WBS). Sensitivity, specificity, and diagnostic accuracy of 18F-FDG PET/CT were 92.5, 90.2, and 91.4 %, respectively. 18F-FDG PET/CT results had an impact on therapy in 38.3 % of patients. One year after initial therapy, 45.7 % showed excellent response, 8.6 % acceptable response, and 45.7 % incomplete response. A statistically significant relationship was found between negative 18F-FDG PET/CT and excellent response (80 vs. 12.2 %, p < 0.001; OR 52.8). 18F-FDG PET/CT scan performed early in surveillance of patients with high/intermediate-risk thyroid carcinoma provides important additional information not available with conventional follow-up methods and had a high impact on therapy. A negative 18F-FDG PET/CT predicts an excellent response to therapy in the new ongoing risk stratification.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Virgen de las Nieves University Hospital, Granada, Spain

    E. M. Triviño Ibáñez, M. A. Muros & J. M. Llamas Elvira

  2. Department of Endocrinology and Metabolism, San Cecilio University Hospital, Granada, Spain

    E. Torres Vela

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  1. E. M. Triviño Ibáñez
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Correspondence to E. M. Triviño Ibáñez.

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Triviño Ibáñez, E.M., Muros, M.A., Torres Vela, E. et al. The role of early 18F-FDG PET/CT in therapeutic management and ongoing risk stratification of high/intermediate-risk thyroid carcinoma. Endocrine 51, 490–498 (2016). https://doi.org/10.1007/s12020-015-0708-5

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