18F-fluorodeoxyglucose positron emission tomography and computed tomography in anaplastic thyroid cancer.

Abstract

PURPOSE:

Our aim was to evaluate in anaplastic thyroid carcinoma (ATC) patients the value of 18F-FDG PET/CT compared with total body computed tomography (CT) using intravenous contrast material for initial staging, prognostic assessment, therapeutic monitoring and follow-up.

METHODS:

Twenty consecutive ATC patients underwent PET/CT for initial staging. PET/CT was performed again during follow-up. The gold standard was progression on imaging follow-up (CT or PET/CT) or confirmation with another imaging modality.

RESULTS:

A total of 265 lesions in 63 organs were depicted in 18 patients. Thirty-five per cent of involved organs were demonstrated only with PET/CT and one involved organ only with CT. In three patients, the extent of disease was significantly changed with PET/CT that demonstrated unknown metastases. Initial treatment modalities were modified by PET/CT findings in 25% of cases. The volume of FDG uptake (≥300 ml) and the intensity of FDG uptake (SUVmax≥18) were significant prognostic factors for survival. PET/CT permitted an earlier assessment of tumour response to treatment than CT in 4 of the 11 patients in whom both examinations were performed. After treatment with combined radiotherapy and chemotherapy, only the two patients with a negative control PET/CT had a confirmed complete remission at 14 and 38 months; all eight patients who had persistent FDG uptake during treatment had a clinical recurrence and died.

CONCLUSION:

FDG PET/CT appears to be the reference imaging modality for ATC at initial staging and seems promising in the early evaluation of treatment response and follow-up.

• Authors: Thomas Poisson, Désirée Deandreis, Sophie Leboulleux, François Bidault, Guillaume Bonniaud, Sylvain Baillot, Anne Aupérin, Abir Al Ghuzlan, Jean-Paul Travagli, Jean Lumbroso, Eric Baudin, Martin Schlumberger
• Journal: European journal of nuclear medicine and molecular imaging (Eur J Nucl Med Mol Imaging) Vol. 37 Issue 12 Pg. 2277-85 (Dec 2010) ISSN: 1619-7089 [Electronic] Germany
• PMID: 20694463 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Radiopharmaceuticals
• Fluorodeoxyglucose F18

Topics

• Adult
• Aged
• Aged, 80 and over
• Female
• Fluorodeoxyglucose F18
• Humans
• Male
• Middle Aged
• Positron-Emission Tomography (methods)
• Radiopharmaceuticals
• Reproducibility of Results
• Sensitivity and Specificity
• Thyroid Carcinoma, Anaplastic
• Thyroid Neoplasms (diagnostic imaging)
• Tomography, X-Ray Computed (methods)
• Whole Body Imaging (methods)