Could [18]F-fluorodeoxyglucose PET/CT change the therapeutic management of stage IV thyroid cancer with positive (131)I whole body scan?

摘要: AIM Stage-IV differentiated thyroid cancer (DTC) patients may present elevated serum thyroglobulin (Tg) levels associated with positive [(131)I] whole-body-scan (WBS). Nevertheless some in whom WBS does not reveal new sites of disease show increased Tg levels. This finding prompts thorough restaging order to exclude the presence metastases unable concentrate iodine. The aim our study was evaluate impact [(18)F]FDG-PET/CT both assessment overall extent and therapeutic management a group stage-IV DTC patients. METHODS On suspicious non-iodine concentrating additional metastases, 20 increasing stable post-therapy were enrolled. Conventional imaging (CI) procedures, including neck ultrasonography, bone-scintigraphy computed tomography (CT) performed before [(18)F]FDG-PET/CT. RESULTS 16 out (80%). In 9 (45%) [(18)F]FDG PET/CT detected larger number tumour recurrences/metastatic than WBS+CI. findings prompted modification 11 (55%), surgery or external radiotherapy eventually considered more appropriate radioactive iodine therapy. These further therapies improved quality life several but did change their survival rate. CONCLUSION Our results showed that [18F]FDG-PET/CT can detect radioiodine-negative advanced unchanged constitute useful tool choice best strategy such difficult cases.