Clinical relevance of 18F-FDG PET/CT in the postoperative follow-up of patients with history of medullary thyroid cancer Cover

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Clinical relevance of 18F-FDG PET/CT in the postoperative follow-up of patients with history of medullary thyroid cancer

Radiology and Oncology

Volume 55 (2021): Issue 1 (March 2021)

By: Jelena Saponjski, Djuro Macut, Dragana Sobic Saranovic, Branislava Radovic and Vera Artiko

Open Access

|Nov 2020

Figures & Tables

Patient with diagnosis of MTC after total thyroidectomy. (A, B) FDG PET/CT confirmed high uptake metastases in the mediastinal lymph nodes and uneven distribution of FDG in the liver. (C)99mTc-DMSA spot view scintigraphy finding is negative. (D)99mTc - tektrotyd SPECT finding is negative. (E)123I – MIBG WB finding showed high uptake in multiple liver metastases. (F)123I – MIBG SPECT finding showed high uptake in multiple liver metastases.

Patient with diagnosis of MTC after total thyroidectomy. (A, B) FDG PET/ CT confirmed high uptake metastases in the lymph nodes of the neck, mediastinum and abdomen. (C)99mTc-DMSA planar spot view scintigraphy showed uptake only in the few lymph nodes in the neck and mediastinum.

Patient with diagnosis of MTC after total thyroidectomy. (A) FDG PET/CT confirmed high uptake in metastases in the mediastinal lymph nodes. (B)99mTc- tektrotyd scintigraphy confirmed high uptake in metastases in the mediastinal lymph nodes. (C)99mTc-DMSA planar spot view scintigraphy finding was negative showed uptake only in the few lymph nodes in the neck and mediastinum.

Kaplan Meier progression-free survival curve in positive FDG patients with median survival of 15 months (95% CI 11.14 ± 18.85 months), while median survival in disease free patients was 30 months (95% CI 1.08+58.92 months).

Concordance of the 18F-FDG PET/CT findings with the results of other radionuclide methods in selected number of medullary thyroid carcinoma patients

¹⁸F-FDG PET/CT	^99mTc(V)-DMSA	^99mTc-HYNIC-TOC	¹²³I-MIBG
14 TP (100%)	4 TP (28.6%)	5 TP (35.7%)	3 TP (21.4%)
	4 FN (28.6%)	3 FN (21.4%)	2 FN (14.3%)
14 TN (100%)	11 TN (78.6%)	1 FP (7%)	3 TN (21.4%)
	2 FP (14.3%)	1 TN (7%)	2 FP (14.3%)
	1 FP (25%)
4 FP (100%)	2 TN (50%)	1 FP (7%)
1 FN (100%)	1 FN (100%)		1 FN (100%)

18F-FDG PET/CT findings in medullary thyroid carcinoma patients with calcitonin levels

Findings	Number	%	Increased calcitonin levels		Calcitonin levels above 1000 pg/ml
TP	35/67	52.2		35/35 (100%)	18/35 (51%)
TN	25/67	37.3		18/25 (72%)	0
FP	4/67	6		2/4 (50%)	0
FN	3/67	4.5		2/3 (66%)	2/3 (66%)
Sensitivity		92.11% (95% CI 78.62% to 98.34%)
Specificity		86.21% (95% CI 68.34% to 96.11%)
Positive predictive value		89.74% (95% CI 77.81% to 95.62%
Negative predictive value		89.29% (95% CI 73.59% to 96.14%)
Accuracy		89.55% (95% CI 79.65% to 95.70%)

99mTc-DMSA scintigraphy findings in medullary thyroid carcinoma patients

Findings	Number	%
TP	4
TN	13
FP	3
FN	5
Sensitivity		44.44% (95% CI 13.70% to 78.80%)
Specificity		81.25% (95% CI 54.35% to 95.95%)
Positive predictive value		57.14% (95% CI 27.55% to 82.38%)
Negative predictive value		72.22% (95% CI 58.07% to 83.00%)
Accuracy		68.00% (95% CI 46.50% to 85.05%)

DOI: https://doi.org/10.2478/raon-2020-0069 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099

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Language: English

Page range: 18 - 25

Submitted on: Aug 6, 2020

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Accepted on: Oct 17, 2020

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Published on: Nov 22, 2020

Published by: Association of Radiology and Oncology

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

¹⁸F-FDG PET/CT,

medullary thyroid carcinoma,

Related subjects:

Clinical medicine,

Internal medicine,

Haematology, oncology,

© 2020 Jelena Saponjski, Djuro Macut, Dragana Sobic Saranovic, Branislava Radovic, Vera Artiko, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

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