Imaging in Thyroid Cancer

Galloway, Richard J.; Smallridge, Robert C.

doi:10.1016/s0889-8529(05)70314-5

Cited by 43 publications

(15 citation statements)

References 49 publications

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“…Entretanto, essas téc-nicas de imagem podem ser negativas apesar de evidências bioquímicas de doença metastática. Outro problema refere-se à sua baixa especificidade, em casos de anatomia alterada após tratamento cirúrgico, devido a dificuldades na diferenciação entre cicatrizes e fibrose de recorrência local, e entre aumentos ganglionares inespecíficos de metástases ganglionares (4).…”

Section: (Arq Bras Endocrinol Metab 2007;51/6:961-971)unclassified

Utilidade da tomografia de emissão de pósitrons com fluoro-deoxiglicose (FDG-PET) na avaliação do câncer de tireóide: uma revisão sistemática

Kuba

Caetano

Coeli

2007

Arq Bras Endocrinol Metab

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RESUMOApós o tratamento inicial do câncer tireoidiano, a detecção de prováveis recorrências e/ou metástases se faz através da dosagem de marcadores séricos e estudos de imagem. Essas técnicas podem ser negativas apesar de evidências bioquímicas de doença metastática. A tomografia de emissão de pósitrons com fluorodeoxiglicose (FDG-PET) tem sido proposta como um teste acurado para detectá-la. O objetivo deste estudo é apresentar uma síntese das evidências obtidas através de revisão sistemática sobre a acurácia do FDG-PET na localização de metástases de câncer tireoidiano previamente tratado, nos quais as modalidades convencionais falharam na sua detecção. Foi realizada uma pesquisa bibliográfica no MEDLINE de todos os trabalhos relativos a FDG-PET e carcinoma tireoidiano diferenciado, indexados até setembro de 2005. Foram obtidas 216 citações e 17 trabalhos foram incluídos, 71% publicados a partir de 2000. A sensibilidade da FDG-PET foi elevada, com apenas um trabalho apresentando sensibilidade inferior a 75%. A especificidade, examinada em 12 estudos, foi menor que 75% em 3 estudos. Em 41% dos trabalhos existia pelo menos um teste comparativo com o FDG-PET. Os resultados apontam o FDG-PET como um teste diagnóstico útil para a detecção e localização de metástases do câncer tireoidiano, com implicações diretas no tratamento dos pacientes. ABSTRACT Utility of Positron Emission Tomography with Fluorodeoxyglucose (FDG-PET) in the Evaluation of Thyroid Cancer: a Systematic Review.After the initial thyroid cancer treatment, the detection of likely recurrences and/or metastases is made through the measurement of serum markers determinations and diagnostic image procedures. These techniques may be negative in spite of biochemical evidence of metastatic disease. The positron emission tomography with fluorodeoxyglucose (FDG-PET) has been proposed as an accurate method to detect it. The aim of this study is to present a synthesis of the evidences obtained from a systematic review regarding FDG-PET accuracy in locating suspected metastases of previously treated thyroid cancer, when the conventional methods failed to do it. A bibliographic review of all studies related to FDG-PET and differentiated thyroid cancer was made on MEDLINE, indexed until September 2005. Two hundred and sixteen citations were collected and 17 studies included, 71% were published after 2000. FDG-PET sensibility was high, with only one study presenting a sensibility lower than 75%. The specificity, examined in 12 studies was lower than 75% in 3 studies. There was at least one test compared to FDG-PET in 41% of the studies. The results point to FDG-PET as a useful diagnostic test to detect and localize thyroid cancer metastases, with direct implications in the treatment of these patients.

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Section: (Arq Bras Endocrinol Metab 2007;51/6:961-971)unclassified

Utilidade da tomografia de emissão de pósitrons com fluoro-deoxiglicose (FDG-PET) na avaliação do câncer de tireóide: uma revisão sistemática

Kuba

Caetano

Coeli

2007

Arq Bras Endocrinol Metab

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“…It is a thyroid-speci¢c protein that is closely involved in the synthesis of triiodothyronine (T 3 ) and T 4 . Approximately 10% of the weight of Tg is carbohydrate, but the molecule is also sulphated and contains phosphate.…”

Section: Structure Of Tgmentioning

confidence: 99%

“…Patients with thyroid cancer are treated postthyroidectomy with suppressive doses of T 4 . This results in low or undetectable serum Tg concentrations and poor uptake of radioiodine during diagnostic scanning.…”

Section: The Futurementioning

confidence: 99%

“…Life -long follow-up of patients with DTC is usually based on clinical examination, measurement of serum Tg and 131 I total body scanning, often after withdrawal of T 4 . Ultrasonography may also be used and, more recently, positron emission tomography scanning 4 and the in vivo use of recombinant TSH have been advocated.…”

mentioning

confidence: 99%

“…Ultrasonography may also be used and, more recently, positron emission tomography scanning 4 and the in vivo use of recombinant TSH have been advocated. All these methods will have their limitations.…”

mentioning

confidence: 99%

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Can we measure serum thyroglobulin?

Clark¹,

Beckett

2002

Ann Clin Biochem

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Measurement of serum thyroglobulin (Tg) by immunoassay is used to monitor the treatment of differentiated thyroid cancer. An understanding of the disease process and the biochemistry of Tg allows the laboratory to determine the characteristics of suitable Tg assays. There are a number of key analytical issues: standardization, long-term assay stability, minimum detection limit, working range and the effect of endogenous Tg antibodies (TgAb). There are signi cant limitations to the methods used to determine TgAb interference. Clinicians should be aware of the limitations of immunoassays for this tumour marker.

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