The added benefit of a dedicated neck F-18 FDG PET-CT imaging protocol in patients with suspected recurrent differentiated thyroid carcinoma

Clin Nucl Med. 2008 Jul;33(7):464-8. doi: 10.1097/RLU.0b013e31817792c9.

Abstract

Purpose: To retrospectively analyze whether adding a delayed high-resolution dedicated neck F-18 FDG positron emission tomography-computerized tomographic (PET-CT) imaging protocol in patients with recurrent differentiated thyroid cancer increases the number of abnormal foci within the neck.

Materials and methods: Seventeen PET-CT studies from a total of 10 patients with suspected recurrent differentiated thyroid cancer between March 2003 and June 2004 were retrospectively reviewed. Each study included a whole body acquisition (WBA), followed by higher resolution dedicated neck acquisition (DNA). Two board-certified nuclear medicine physicians reviewed either the DNA or WBA for each study and recorded the number of abnormal foci, along with presence or absence of a soft tissue abnormality, and maximum standardized uptake value for each foci. Consensus review was used for all discrepancies. Statistical analysis was performed to determine whether there was a statistically significant increase in the number of studies demonstrating new abnormal foci with the addition of a DNA.

Results: Five of 17 studies demonstrated an increase in the number of abnormal foci with the addition of the DNA (P < 0.04). A total of 8 abnormal foci were noted on the WBA, 4 of which were within the neck. Eleven additional abnormal foci were seen on the DNA. All abnormal foci within the neck had corresponding soft tissue abnormalities except for one.

Conclusion: Adding a higher resolution delayed DNA to the WBA for patients undergoing PET-CT imaging to detect recurrent thyroid cancer increases the number of abnormal sites of FDG accumulation.

MeSH terms

  • Carcinoma / diagnosis*
  • Carcinoma / diagnostic imaging
  • Carcinoma / pathology*
  • Cell Differentiation
  • Contrast Media / pharmacology
  • DNA / chemistry
  • Fluorodeoxyglucose F18 / pharmacology*
  • Humans
  • Neck / diagnostic imaging
  • Neck / pathology
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Neoplasm Recurrence, Local / pathology
  • Positron-Emission Tomography / methods*
  • Radiopharmaceuticals / pharmacology*
  • Recurrence
  • Retrospective Studies
  • Thyroid Neoplasms / diagnosis*
  • Thyroid Neoplasms / diagnostic imaging
  • Thyroid Neoplasms / pathology*
  • Tomography, X-Ray Computed / methods*
  • Whole Body Imaging

Substances

  • Contrast Media
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • DNA