Nuclear medicine in diagnosis, staging and follow-up of thyroid cancer.

摘要: Diagnostic strategy in thyroid cancer is conditioned by epidemiological, pathophysiological, cost-effective issues changing with age and countries. Nuclear medicine has a role mainly differentiated carcinomas, i.e. the large majority of cancers. In diagnosis nodule 99mTc-perthecnetate indicated patients low TSH levels, multinodular goiter, solid nodules at US negative FNA. Radiolabeled somatostatin analogs or Metaiodobenzylguanidine (MIBG) can be used suspicion medullary carcinoma. There no staging. WBS 131I after surgical resection gland it more suggested before ablative therapy, because possible stunning effect. follow-up thyroglobulin (Tg) test mandatory both therapy withdrawal rhTSH administration. Some authors already suggest to use this alone, as 1st step, carcinoma risk recurrence, but approach not yet generally accepted been validated tumors intermediate/high risk. 131 I ever when autoantibodies affect reliability Tg values presence high levels better define radiometabolic therapy. case WBS, PETFDG proposed. 123 an alternative , its higher costs. The clinical increase accuracy following hypothyroidism, worst prognosis pituitary response.