Abstract
Purpose
To evaluate the value of fluorine-18 2-deoxy-2-d-glucose positron emission tomography/computed tomography ([18F]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 48.7years, range 18–76) who had a total thyroidectomy operation underwent whole-body
[18F]FDG-PET/CT scans. The diagnostic accuracy of [18F]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 6months.
Results
One hundred forty-four suspicious lesions were identified by organ-based analysis.
Of these lesions, [18F]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 1000pg/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% (χ2=4.392, P<.05) and 100% (χ2=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
[18F]FDG-PET/CT has excellent sensitivity and specificity, especially when the calcitonin
value is higher than 1000pg/ml for detecting metastatic medullary thyroid cancer.
Compared to conventional morphologic imaging methods, it provides additional information
for diagnosis.
Keywords
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Article info
Publication history
Published online: May 20, 2014
Accepted:
May 12,
2014
Received in revised form:
April 29,
2014
Received:
February 10,
2014
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
