Postradioiodine Treatment Whole-Body Scan in the Era of 18-Fluorodeoxyglucose Positron Emission Tomography for Differentiated Thyroid Carcinoma with Elevated Serum Thyroglobulin Levels

Leboulleux, Sophie; Bez, I. El; Borget, Isabelle; Elleuch, Manel; Deandreis, Désirèe; Ghuzlan, Abir Al; Chougnet, C.; Bidault, François; Mirghani, Haïtham; Lumbroso, J.; Hartl, Dana M.; Baudin, Éric; Schlumberger, Martin

doi:10.1089/thy.2012.0081

Cited by 73 publications

(78 citation statements)

References 26 publications

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“…When no abnormalities are thus found, one may decide to merely monitor the Tg behavior later or to perform a more thorough investigation based on the Tg [T4] levels and the patient risk category. In the latter case, the traditional recommendation is to perform WBS after the use of radioiodine (100 mCi Thyroid nodules and differentiated thyroid cancer (139,151); however, the latter might also be the first step (138,152,153). When negative Tg [T4] levels increase to levels above 1 ng/ml following TSH-induced stimulation and metastases are not found at the initial assessment, conservative management is recommended when Tg is less than 10 ng/ml following discontinuation of T4 or 5 ng/ml with use of recombinant TSH (91,124,125,138).…”

Section: Recommendation 53mentioning

confidence: 99%

Thyroid nodules and differentiated thyroid cancer: update on the Brazilian consensus

Rosário

Ward

Carvalho

et al. 2013

Arq Bras Endocrinol Metab

122

147

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Thyroid nodules are frequent findings, especially when sensitive imaging methods are used. Although thyroid cancer is relatively rare, its incidence is increasing, particularly in terms of small tumors, which have an uncertain clinical relevance. Most patients with differentiated thyroid cancer exhibit satisfactory clinical outcomes when treatment is appropriate, and their mortality rate is similar to that of the overall population. However, relapse occurs in a considerable fraction of these patients, and some patients stop responding to conventional treatment and eventually die from their disease. Therefore, the challenge is how to identify the individuals who require more aggressive disease management while sparing the majority of patients from unnecessary treatments and procedures. We have updated the Brazilian Consensus that was published in 2007, emphasizing the diagnostic and therapeutic advances that the participants, representing several Brazilian university centers, consider most relevant in clinical practice. The formulation of the present guidelines was based on the participants' experience and a review of the relevant literature. Arq Bras Endocrinol Metab. 2013;57(4):240-64 Keywords Thyroid nodules; thyroid cancer; Brazilian consensus; update RESUMO Nódulos tireoidianos são muito frequentes, sobretudo quando se empregam métodos sensí-veis de imagem. Embora o câncer seja proporcionalmente raro, sua incidência vem aumentando, especialmente de tumores pequenos, cuja evolução clínica é incerta. A maioria dos pacientes com carcinoma diferenciado de tireoide evolui bem quando adequadamente tratada, com índices de mortalidade similares à população geral. Por outro lado, um percentual não desprezível apresenta recidivas e alguns eventualmente não respondem às terapias convencionais, evoluindo para óbito. Assim, o desafio é distinguir os pacientes merecedores de condutas mais agressivas e, ao mesmo tempo e não menos importante, poupar a maioria de tratamentos e procedimentos desnecessários. Atualizamos o Consenso Brasileiro publicado em 2007, ressaltando os avanços diagnósticos e terapêuticos que os participantes, de diferentes Centros Universitários do Brasil, consideram mais relevantes para prática clínica. A elaboração dessas diretrizes foi baseada na experiência dos participantes e revisão da literatura pertinente. Arq Bras Endocrinol Metab. 2013;57(4):240-64 Descritores

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Section: Recommendation 53mentioning

confidence: 99%

Thyroid nodules and differentiated thyroid cancer: update on the Brazilian consensus

Rosário

Ward

Carvalho

et al. 2013

Arq Bras Endocrinol Metab

122

147

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“…However, the role of DxWBS has been questioned because this technique is rarely able to localize disease (5). If no disease sites are identified by chest CT or DxWBS, FDG-PET/CT or empiric RAI therapy followed by WBS (TxWBS) should be performed to identify recurrent or metastatic disease (26,27,28) (Fig. 3).…”

Section: Defined Indicationsmentioning

confidence: 99%

IMAGING IN ENDOCRINOLOGY: 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography in differentiated thyroid carcinoma: clinical indications and controversies in diagnosis and follow-up

Salvatori

Biondi

Rufini

2015

European Journal of Endocrinology

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In recent years, 2-[ 18 F]-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) has emerged as an important tool for the postoperative management of patients with differentiated thyroid cancer (DTC) and it is widely used in selected clinical situations. The most valuable role that FDG-PET/CT plays in clinical practice is that it can be used to obtain prognostic information in patients with increasing thyroglobulin (Tg) levels and negative 131 I whole-body scan post-thyroidectomy and radioiodine (RAI) ablation. FDG-PET/CT may also have a potential role in the initial staging and follow-up of high-risk patients with aggressive histological subtypes, in the identification of patients who are at the highest risk of disease-specific mortality, in the management of patients with RAI-refractory disease, in clinical trials of novel targeted therapies in patients with advanced metastatic disease, and in the evaluation of thyroid nodules with indeterminate fineneedle aspiration for cytology. However, several controversies remain to be resolved, namely: the cutoff value of Tg in the selection of DTC patients for FDG-PET/CT, whether FDG-PET/CT scanning should be performed under thyrotropin stimulation or suppression, and the clinical significance of thyroid FDG-PET/CT incidentalomas. The aim of the present article is to provide an overview of the data about the molecular basis for, clinical indications of, and controversies related to the use of FDG-PET/CT in patients with DTC.

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“…Более оправданно назначение в таких ситуациях мультиспиральной КТ грудной клетки для исключения метастазов в легкие как самой частой мишени отдаленного метастазирования ДРЩЖ. Если вышеописанный диагностический алгоритм не выявил опухолевых очагов, рекомендуется проведение ПЭТ / КТ с 18 ФДГ или курса эмпирической радиойод-терапии с последующей посттерапевтической СВТ (тСВТ) [31][32][33]. Причем, по последним данным лите-ратуры, ПЭТ / КТ с 18 ФДГ обладает преимуществом перед тСВТ, поэтому назначение эмпирической радио-йодтерапии рекомендуется только в случае отсутствия или незначительного накопления ФДГ [31,33].…”

Section: клинические показанияunclassified

“…ПЭТ / КТ была патологической у 22 пациен-тов, у 5 из которых также было выявлено патологиче-ское накопление радиофармпрепарата по тСВТ, только 1 пациент имел патологию по тСВТ и нормальные данные по ПЭТ / КТ. Авторы делают вывод, что у паци-ентов с подозрением на рецидив опухолевого процесса на основании повышенного уровня ТГ после 1-й нор-мальной тСВТ для локализации рецидива должна быть проведена ПЭТ / КТ, а не 2-е пострадиойодтерапевти-ческое сканирование [32].…”

Section: клинические показанияunclassified

The use of 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography in patients with differentiated thyroid cancer after initial treatment

Гелиашвили¹,

Важенин²,

Афанасьева³

2017

Opuholi golovy šei

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Postradioiodine Treatment Whole-Body Scan in the Era of 18-Fluorodeoxyglucose Positron Emission Tomography for Differentiated Thyroid Carcinoma with Elevated Serum Thyroglobulin Levels

Cited by 73 publications

References 26 publications

Thyroid nodules and differentiated thyroid cancer: update on the Brazilian consensus

Thyroid nodules and differentiated thyroid cancer: update on the Brazilian consensus

IMAGING IN ENDOCRINOLOGY: 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography in differentiated thyroid carcinoma: clinical indications and controversies in diagnosis and follow-up

The use of 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography in patients with differentiated thyroid cancer after initial treatment

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