Clinical Usefulness of F-18 FDG PET/CT in Papillary Thyroid Cancer with Negative Radioiodine Scan and Elevated Thyroglobulin Level or Positive Anti-thyroglobulin Antibody

Choi, Su Jung; Jung, Kyung Pyo; Lee, Sun Seong; Park, Yun Soo; Lee, Seok Mo; Bae, Soochan

doi:10.1007/s13139-015-0378-5

Cited by 23 publications

(21 citation statements)

References 22 publications

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“…However, a negative 131 I scintigraphy result in a sTg-positive patient is a diagnostic and therapeutic challenge 11 . Using PET/CT in this group of patients is widely accepted, however, low sensitivity observed in patients with slightly increased sTg levels reflects that higher Tg level may be required to achieve a better FDG-PET accuracy 14 – 17 , 25 , 26 . Recent studies have suggested 99m Tc-3PRGD2 as a promising modality for guiding diagnosis and treatment of metastatic DTC lesions 22 , 27 .…”

Section: Discussionmentioning

confidence: 99%

“…Patients were regarded as recurrence negative if either, (1) histopathological examination by either biopsy or reoperation excluded recurrence, or (2) other imaging modalities did not display recurrent disease and sTg levels spontaneously dropped. Using this definition of recurrence, we evaluated the diagnostic value of 99m Tc-3PRGD2 SPECT/CT to disclose recurrent disease in our patients 2 , 10 – 14 , 37 .…”

Section: Methodsmentioning

confidence: 99%

“…The SPECT/CT results were correlated with Tg levels and clinical and histopathologic characteristics of the primary tumor. In addition, we also stratified these patients per their entry stimulated Tg levels (>30 ng/mL, or >10 but ≤30 ng/mL) and evaluated the correlation between sTg levels and the 99m Tc-3PRGD2 SPECT/CT results 14 .…”

Section: Methodsmentioning

confidence: 99%

“…However, the probability of obtaining a positive FDG PET result in TENIS patients is unsatisfactory, especially in cases with the serum level of sTg lower than 30 ng/mL. In addition, the limited prognostic significance of a negative result also hampered its routine clinical use 14 – 18 . Therefore, alternative imaging modalities to 18 F-FDG PET/CT are requested for the detection of metastatic disease in patients with TENIS syndrome 19 .…”

Section: Introductionmentioning

confidence: 99%

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Clinical Value of 99mTc-3PRGD2 SPECT/CT in Differentiated Thyroid Carcinoma with Negative 131I Whole-Body Scan and Elevated Thyroglobulin Level

Gao

Zhang

Wang

et al. 2018

Sci Rep

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The aim of this study was to assess the usefulness of integrin imaging with 99mTc-PEG4-E[PEG4-c(RGDfK)]2 (99mTc-3PRGD2) single photon emission computed tomography (SPECT)/computed tomography (CT) in detecting recurrent disease in patients with differentiated thyroid cancer (DTC), negative radioiodine whole-body scan (WBS) and high serum thyroglobulin (Tg). Thirty-seven patients who underwent total thyroidectomy followed by radioactive iodine ablation and had negative radioiodine WBS but elevated Tg levels were included. 99mTc-3PRGD2 SPECT/CT was performed 1 week after the negative diagnostic 131I WBS. Diagnostic performance indicators, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), for 99mTc-3PRGD2 SPECT/CT was calculated. The correlations between SPECT/CT results and clinic-pathological characteristics were examined. In 30 (81.1%) of the 37 patients, 99mTc-3PRGD2 SPECT/CT showed positive uptake. The sensitivity, specificity, PPV, and NPV of SPECT/CT to detect recurrent disease at follow-up were 96.6%, 75%, 93.3% and 85.7%, respectively. The sensitivity and PPV of SPECT/CT increased with increasing serum Tg levels. 99mTc-3PRGD2 SPECT/CT showed high sensitivity and PPV in the detection of recurrence among DTC patients with higher Tg levels and negative WBS, and the probability of obtaining a positive SPECT/CT result was related with the level of Tg.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Value of 99mTc-3PRGD2 SPECT/CT in Differentiated Thyroid Carcinoma with Negative 131I Whole-Body Scan and Elevated Thyroglobulin Level

Gao

Zhang

Wang

et al. 2018

Sci Rep

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“…Fluorine-18-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/X-ray computed tomography (PET/CT) is an established imaging modality in cases with TENIS syndrome [ 18 – 20 ]. However, the low probability of obtaining a positive FDG PET result in TENIS patients with sTg levels lower than 30 ng/mL may hamper its clinical use [ 19 , 20 ]. Previous studies have focused on the ability of 99m Tc-PEG4-E [PEG4-c (RGDfK)]2 ( 99m Tc-3PRGD2) SPECT/CT to specifically image metastatic lymph nodes in DTC patients [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Hyperplastic thymus with increased angiogenesis is correlated with elevated serum thyroglobulin level in differentiated thyroid cancer patients with TENIS syndrome

et al. 2017

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AimsTo investigate the association between angiogenetic activity of hyperplastic thymus and serum thyroglobulin (Tg) level in differentiated thyroid carcinoma patients with thyroglobulin (Tg)-elevated Negative Iodine Scintigraphy (TENIS) Syndrome.MethodsA cohort of 30 consecutive patients who underwent total thyroidectomy followed by radioiodine ablation and had TENIS syndrome received integrin αvβ3 targeted imaging with 99mTc-HYNIC-PEG4-E[PEG4-c(RGDfk)]2 (99mTc-3PRGD2). The correlation of angiogenetic activity of the thymus and the serum Tg levels was evaluated in patients with enlarged thymus.ResultsEnlarged thymus was detected in 9 out of the 30 TENIS patients and all hyperplastic thymus showed an increased accumulation of the tracer (median tumor/background ratio: 2.8). Five of them had only mediastinal uptake and surgical removal of the mediastinal mass in one provided histopathologic evidence of thymic tissue. The other four were not assigned further treatment and were free of disease in the follow-up, though their stimulated Tg levels consistently increased. Four out of the 9 patients showed 99mTc-3PRGD2 uptake outside the mediastinum were assigned surgery followed by radioiodine treatment. Their stimulated Tg levels decreased after iodine ablation, but not drop back to normal. A significant linear correlation was observed between serum Tg levels and the degree of angiogenesis in the hyperplastic thymus.ConclusionsThe angiogenetic activity in hyperplastic thymus was related with the consistently elevated serum Tg levels in TENIS syndrome patients. Based on the existing literature and current data, we propose further intervention for patients with RGD uptake outside thymus, while close follow-up for patients with only mediastinal uptake.

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FDG PET Hybrid Imaging

Becker¹,

Schwarzenböck²,

Krause³

2020

Recent Results in Cancer Research

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Clinical Usefulness of F-18 FDG PET/CT in Papillary Thyroid Cancer with Negative Radioiodine Scan and Elevated Thyroglobulin Level or Positive Anti-thyroglobulin Antibody

Cited by 23 publications

References 22 publications

Clinical Value of 99mTc-3PRGD2 SPECT/CT in Differentiated Thyroid Carcinoma with Negative 131I Whole-Body Scan and Elevated Thyroglobulin Level

Clinical Value of 99mTc-3PRGD2 SPECT/CT in Differentiated Thyroid Carcinoma with Negative 131I Whole-Body Scan and Elevated Thyroglobulin Level

Hyperplastic thymus with increased angiogenesis is correlated with elevated serum thyroglobulin level in differentiated thyroid cancer patients with TENIS syndrome

FDG PET Hybrid Imaging

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