Post-PET ultrasound improves specificity of 18F-FDG-PET for recurrent differentiated thyroid cancer while maintaining sensitivity

Acta Radiologica
Martin BiermannMichael Brauckhoff

Abstract

Positron emission tomography (PET) using fluor-18-deoxyglucose (18F-FDG) with or without computed tomography (CT) is generally accepted as the most sensitive imaging modality for diagnosing recurrent differentiated thyroid cancer (DTC) in patients with negative whole body scintigraphy with iodine-131 (I-131). To assess the potential incremental value of ultrasound (US) over 18F-FDG-PET-CT. Fifty-one consecutive patients with suspected recurrent DTC were prospectively evaluated using the following multimodal imaging protocol: (i) US before PET (pre-US) with or without fine needle biopsy (FNB) of suspicious lesions; (ii) single photon emission computed tomography (≥3 GBq I-131) with co-registered CT (SPECT-CT); (iii) 18F-FDG-PET with co-registered contrast-enhanced CT of the neck; (iv) US in correlation with the other imaging modalities (post-US). Postoperative histology, FNB, and long-term follow-up (median, 2.8 years) were taken as composite gold standard. Fifty-eight malignant lesions were identified in 34 patients. Forty lesions were located in the neck or upper mediastinum. On receiver operating characteristics (ROC) analysis, 18F-FDG-PET had a limited lesion-based specificity of 59% at a set sensitivity of 90%. Pre-US had p...Continue Reading

References

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Citations

Dec 19, 2015·World Journal of Surgery·Katrin BrauckhoffMichael Brauckhoff
Aug 11, 2020·Current Opinion in Endocrinology, Diabetes, and Obesity·Katrin Brauckhoff, Martin Biermann
Oct 27, 2020·Nuklearmedizin. Nuclear Medicine·Martin BiermannRobert Gray
May 4, 2021·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Hao FuLibo Chen

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Methods Mentioned

BETA
biopsy
dissection

Software Mentioned

MDcake
R package pROC

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