Combined PET/CT with iodine-124 in diagnosis of spread metastatic thyroid carcinoma: a case report

Abstract

Iodine-124 positron emission tomography (PET) is a useful 3D imaging technique for diagnosis and management of thyroid diseases. The difficulty in interpretation of the PET scans with highly selective tracers, such as iodine-124, is the lack of identifiable anatomical structures, so an accurate anatomical localization of foci presenting abnormal uptake is problematic. Consequently, a combined PET/CT scanner can resolve these difficulties by co-registering PET and CT data in a single session allowing a correlation of functional and morphologic imaging. A case is presented where iodine-124 produced by a clinical cyclotron and FDG were used to acquire images with a combined PET/CT scanner for clinical staging. On the basis of the PET/CT exams the treatment of the patient was modified.

Value of 124I-PET/CT in staging of patients with differentiated thyroid cancer

“…This shortcoming of diagnostic procedures using radioactive iodine is subdued by PET/CT as we firstly could show in this study. This data confirms the promising results of first case studies from our group [16][17][18].…”

“…In CT alone, especially primary malignancies, lymph node metastasis [17,18] and small metastases involving the bone were not detected. On the other hand, CT showed iodine-negative pulmonary metastases in 4/12 (33%) patients [16] and thus was highly accurate in the diagnosis of organ metastases.…”

“…By acquiring both PET and CT data sets in a single scan session using a combined PET/CT tomograph, the PET and CT data can be acquired in a single session and the resulting imaging sets are intrinsically co-registrated [14,15]. Until now, only a few case-reports concerning 124 I-PET/CT have been published showing the potential of this new and innovative imaging tool [16][17][18].…”

Lobar mucinous bronchioloalveolar carcinoma of the lung showing negative FDG uptake on integrated PET/CT

“…Most malignant tumors have a higher rate of glucose metabolism than normal tissue; therefore, exhibit a higher FDG uptake than background tissue [1][2][3][4][5][6].…”

“…It has been well known that most malignant tumors have a higher rate of glucose metabolism than normal tissue [1][2][3][4][5][6]. However, 18 Fluoro-2-deoxy-D-glucose (FDG) uptake has a wide variation in tumor glucose metabolic rate, depending on the histologic type and aggressiveness of the tumor [7][8][9][10].…”