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Clinical value of [18F]FDG-PET/CT in the detection of metastatic medullary thyroid cancer

  • Author Footnotes
    1 Jinjin Jiang and Zhongyi Yang contributed equally to the paper.
    Jinjin Jiang
    Footnotes
    1 Jinjin Jiang and Zhongyi Yang contributed equally to the paper.
    Affiliations
    Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China

    Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
    Search for articles by this author
  • Author Footnotes
    1 Jinjin Jiang and Zhongyi Yang contributed equally to the paper.
    Zhongyi Yang
    Footnotes
    1 Jinjin Jiang and Zhongyi Yang contributed equally to the paper.
    Affiliations
    Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China

    Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
    Search for articles by this author
  • Yongping Zhang
    Affiliations
    Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China

    Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
    Search for articles by this author
  • Xiaoping Xu
    Affiliations
    Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China

    Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
    Search for articles by this author
  • Mingwei Wang
    Affiliations
    Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China

    Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
    Search for articles by this author
  • Silong Hu
    Affiliations
    Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China

    Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
    Search for articles by this author
  • Zhifeng Yao
    Affiliations
    Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China

    Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
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  • Herong Pan
    Affiliations
    Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China

    Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
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  • Yingjian Zhang
    Affiliations
    Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai, China

    Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
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  • Duanshu Li
    Correspondence
    Corresponding author. No. 270, Dong'an Road, Xuhui District, Shanghai, China. Tel.: +86 21 64175590 6908; fax: +86 21 54520250.
    Affiliations
    Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China

    Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
    Search for articles by this author
  • Author Footnotes
    1 Jinjin Jiang and Zhongyi Yang contributed equally to the paper.

      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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