Πέμπτη 26 Μαρτίου 2020

Pre-Ablation rhTSH-Stimulated F-18 FDG PET/CT Changes Patient Management in Increased-Risk Thyroid Cancer

Pre-Ablation rhTSH-Stimulated F-18 FDG PET/CT Changes Patient
Management in Increased-Risk Thyroid Cancer:

Horm Metab Res 2020; 52: 158-167
DOI: 10.1055/a-1111-8927

The aim of the study was to evaluate the clinical impact of pre-ablation
rhTSH-stimulated fluorine-18 fluorodeoxyglucose (F-18 FDG) PET/CT in
addition to post-therapeutic whole body radioiodine scanning in patients
with intermediate to high risk differentiated thyroid carcinoma (DTC). This
was a retrospective single center study including 73 patients with thyroid
cancer (44 females, mean age 43.2±16.2 years, 62% papillary,
31% follicular, 7% poorly differentiated). All patients
underwent ablative radioiodine treatment (mean activity: 3661±673
MBq I-131) using rhTSH after thyroidectomy and lymph node (LN) dissection
(01/2013–10/2016) and TSH-stimulated F-18 FDG
PET/CT (4 MBq/kg body weight, low dose CT). Post-treatment
I-131 whole body scan (I-131 WBS) was obtained 9 days afterwards in planar
technique and in case of equivocal or abnormal findings using
SPECT/CT. Thirty-one patients (42%) showed F-18 FDG avid
lesions, 14 patients showed more FDG than iodine positive lesions and 5
patients more iodine positive lesions in I-131 WBS, respectively.
Fifty-three patients showed identical F-18 FDG PET/CT and I-131 WBS.
The initial treatment plan was changed from follow-up to therapy (surgery,
systemic therapy using tyrosine-kinase inhibition) in 11 patients
(15%) on the basis of F-18 FDG PET/CT imaging. Six of these
11 patients had papillary thyroid cancer. Three patients with histologically
proven LN metastases had stimulated
thyroglobulin-levels<2.0 ng/ml. Our study
demonstrated a clinical benefit of pre-ablation rhTSH-stimulated F-18 FDG
PET/CT imaging in about 20% of patients with intermediate to
high risk DTC, leading to change in patient management in 15%.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  open access Full text

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