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Incremental Value of a Dedicated Head and Neck Acquisition during 18F-FDG PET/CT in Patients with Differentiated Thyroid Cancer
18F-FDG-PET/CT is a useful tool used to evidence persistent/recurrent disease (PRD) in patients with differentiated thyroid cancer and iodine-refractory lesions. The aim of this study was to compare the diagnostic value at the cervical level of the routine whole-body (WB) acquisition and that of a c...
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| Published in: | PloS one 2016-09, Vol.11 (9), p.e0162482-e0162482 |
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| creator | Ciappuccini, Renaud Aide, Nicolas Blanchard, David Rame, Jean-Pierre de Raucourt, Dominique Michels, Jean-Jacques Babin, Emmanuel Bardet, Stéphane |
| description | 18F-FDG-PET/CT is a useful tool used to evidence persistent/recurrent disease (PRD) in patients with differentiated thyroid cancer and iodine-refractory lesions. The aim of this study was to compare the diagnostic value at the cervical level of the routine whole-body (WB) acquisition and that of a complementary head and neck (HN) acquisition, performed successively during the same PET/CT study.
PET/CT studies combining WB and HN acquisitions performed in 85 consecutive patients were retrospectively reviewed by two nuclear medicine physicians. 18F-FDG uptake in cervical lymph nodes (LN) or in the thyroid bed was assessed. Among the 85 patients, the PET/CT results of the 26 who subsequently underwent neck surgery were compared with surgical and pathological reports. The size of each largest nodal metastasis was assessed by a pathologist.
In the 85 patients, inter-observer agreement was excellent for both WB and HN PET/CT interpretation. Of the 26 patients who underwent surgery, 25 had pathology proven PRD in the neck. Of these 25 patients, 15 displayed FDG uptake on either WB or HN PET. In these 15 patients, HN PET detected more malignant lesions than WB PET did (21/27 = 78% vs. 12/27 = 44%, P = 0.006). Node/background ratios were significantly higher on HN than on WB PET (P |
| doi_str_mv | 10.1371/journal.pone.0162482 |
| format | article |
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PET/CT studies combining WB and HN acquisitions performed in 85 consecutive patients were retrospectively reviewed by two nuclear medicine physicians. 18F-FDG uptake in cervical lymph nodes (LN) or in the thyroid bed was assessed. Among the 85 patients, the PET/CT results of the 26 who subsequently underwent neck surgery were compared with surgical and pathological reports. The size of each largest nodal metastasis was assessed by a pathologist.
In the 85 patients, inter-observer agreement was excellent for both WB and HN PET/CT interpretation. Of the 26 patients who underwent surgery, 25 had pathology proven PRD in the neck. Of these 25 patients, 15 displayed FDG uptake on either WB or HN PET. In these 15 patients, HN PET detected more malignant lesions than WB PET did (21/27 = 78% vs. 12/27 = 44%, P = 0.006). Node/background ratios were significantly higher on HN than on WB PET (P<0.0001). Three false-negative studies (20%) on WB PET were upstaged as true-positive on HN PET. The mean size of the largest LN metastasis was 3 mm for the LN detected neither on WB nor on HN PET, 7 mm for the metastasis detected on HN but not on WB PET, and 13 mm for those detected on both acquisitions (P = 0.0004). Receiver-Operating Characteristic analysis showed that area under the curve was higher for HN PET than for WB PET (0.97 [95%CI, 0.90-0.99] vs 0.88 [95%CI, 0.78-0.95], P = 0.009).
HN acquisition improves the ability to detect PRD in the neck compared with WB acquisition alone. We recommend systematically adding an HN acquisition when PET/CT is performed to detect PRD in the neck.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0162482</identifier><identifier>PMID: 27598385</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adenocarcinoma - diagnostic imaging ; Adenocarcinoma - metabolism ; Adenocarcinoma - pathology ; Adenocarcinoma - surgery ; Adult ; Aged ; Algorithms ; Area Under Curve ; Biology and Life Sciences ; Cancer ; Diagnostic systems ; Female ; Fluorodeoxyglucose F18 - pharmacokinetics ; Humans ; Iodine ; Lesions ; Lymph nodes ; Lymphatic Metastasis ; Male ; Medical imaging ; Medical personnel ; Medicine and Health Sciences ; Metastases ; Metastasis ; Middle Aged ; Neck ; Neoplasm Recurrence, Local - diagnostic imaging ; Neoplasm Recurrence, Local - metabolism ; Neoplasm Recurrence, Local - pathology ; Neoplasm Recurrence, Local - surgery ; Nuclear medicine ; Observer Variation ; Pathology ; Patients ; Physicians ; Positron emission ; Positron emission tomography ; Positron Emission Tomography Computed Tomography ; Radiopharmaceuticals - pharmacokinetics ; Research and Analysis Methods ; Retrospective Studies ; ROC Curve ; Surgery ; Surgical instruments ; Thyroid ; Thyroid cancer ; Thyroid Neoplasms - diagnostic imaging ; Thyroid Neoplasms - metabolism ; Thyroid Neoplasms - pathology ; Thyroid Neoplasms - surgery ; Tomography ; Ultrasonic imaging</subject><ispartof>PloS one, 2016-09, Vol.11 (9), p.e0162482-e0162482</ispartof><rights>2016 Ciappuccini et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2016 Ciappuccini et al 2016 Ciappuccini et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4042-ffd6a1c280bed6b87d2882ec56efc9e3ac9ca0dcf4fe4049fa4cfbeaab223f6f3</citedby><cites>FETCH-LOGICAL-c4042-ffd6a1c280bed6b87d2882ec56efc9e3ac9ca0dcf4fe4049fa4cfbeaab223f6f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/1817094336/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1817094336?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,25731,27901,27902,36989,36990,44566,53766,53768,74869</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27598385$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ciappuccini, Renaud</creatorcontrib><creatorcontrib>Aide, Nicolas</creatorcontrib><creatorcontrib>Blanchard, David</creatorcontrib><creatorcontrib>Rame, Jean-Pierre</creatorcontrib><creatorcontrib>de Raucourt, Dominique</creatorcontrib><creatorcontrib>Michels, Jean-Jacques</creatorcontrib><creatorcontrib>Babin, Emmanuel</creatorcontrib><creatorcontrib>Bardet, Stéphane</creatorcontrib><title>Incremental Value of a Dedicated Head and Neck Acquisition during 18F-FDG PET/CT in Patients with Differentiated Thyroid Cancer</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>18F-FDG-PET/CT is a useful tool used to evidence persistent/recurrent disease (PRD) in patients with differentiated thyroid cancer and iodine-refractory lesions. The aim of this study was to compare the diagnostic value at the cervical level of the routine whole-body (WB) acquisition and that of a complementary head and neck (HN) acquisition, performed successively during the same PET/CT study.
PET/CT studies combining WB and HN acquisitions performed in 85 consecutive patients were retrospectively reviewed by two nuclear medicine physicians. 18F-FDG uptake in cervical lymph nodes (LN) or in the thyroid bed was assessed. Among the 85 patients, the PET/CT results of the 26 who subsequently underwent neck surgery were compared with surgical and pathological reports. The size of each largest nodal metastasis was assessed by a pathologist.
In the 85 patients, inter-observer agreement was excellent for both WB and HN PET/CT interpretation. Of the 26 patients who underwent surgery, 25 had pathology proven PRD in the neck. Of these 25 patients, 15 displayed FDG uptake on either WB or HN PET. In these 15 patients, HN PET detected more malignant lesions than WB PET did (21/27 = 78% vs. 12/27 = 44%, P = 0.006). Node/background ratios were significantly higher on HN than on WB PET (P<0.0001). Three false-negative studies (20%) on WB PET were upstaged as true-positive on HN PET. The mean size of the largest LN metastasis was 3 mm for the LN detected neither on WB nor on HN PET, 7 mm for the metastasis detected on HN but not on WB PET, and 13 mm for those detected on both acquisitions (P = 0.0004). Receiver-Operating Characteristic analysis showed that area under the curve was higher for HN PET than for WB PET (0.97 [95%CI, 0.90-0.99] vs 0.88 [95%CI, 0.78-0.95], P = 0.009).
HN acquisition improves the ability to detect PRD in the neck compared with WB acquisition alone. We recommend systematically adding an HN acquisition when PET/CT is performed to detect PRD in the neck.</description><subject>Adenocarcinoma - diagnostic imaging</subject><subject>Adenocarcinoma - metabolism</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Algorithms</subject><subject>Area Under Curve</subject><subject>Biology and Life Sciences</subject><subject>Cancer</subject><subject>Diagnostic systems</subject><subject>Female</subject><subject>Fluorodeoxyglucose F18 - pharmacokinetics</subject><subject>Humans</subject><subject>Iodine</subject><subject>Lesions</subject><subject>Lymph nodes</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical personnel</subject><subject>Medicine and Health Sciences</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Neck</subject><subject>Neoplasm Recurrence, Local - diagnostic imaging</subject><subject>Neoplasm Recurrence, Local - metabolism</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Recurrence, Local - surgery</subject><subject>Nuclear medicine</subject><subject>Observer Variation</subject><subject>Pathology</subject><subject>Patients</subject><subject>Physicians</subject><subject>Positron emission</subject><subject>Positron emission tomography</subject><subject>Positron Emission Tomography Computed Tomography</subject><subject>Radiopharmaceuticals - pharmacokinetics</subject><subject>Research and Analysis Methods</subject><subject>Retrospective Studies</subject><subject>ROC Curve</subject><subject>Surgery</subject><subject>Surgical instruments</subject><subject>Thyroid</subject><subject>Thyroid cancer</subject><subject>Thyroid Neoplasms - diagnostic imaging</subject><subject>Thyroid Neoplasms - metabolism</subject><subject>Thyroid Neoplasms - pathology</subject><subject>Thyroid Neoplasms - surgery</subject><subject>Tomography</subject><subject>Ultrasonic imaging</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNqNkk9vEzEQxVcIREvhGyCw1AuXpP6za3svSFXStJEq6CFwtWbtceKwWafeXVBPfHU2TVq1iAMn2-P3fp6xXpa9Z3TMhGJn69inBurxNjY4pkzyXPMX2TErBR9JTsXLJ_uj7E3brikthJbydXbEVVFqoYvj7Pe8sQk32HRQk-9Q90iiJ0Cm6IKFDh25QnAEGke-oP1Bzu1tH9rQhdgQ16fQLAnTs9FsekluLhZnkwUJDbmBLgzElvwK3YpMg_eYhnO45y1WdykGRybQWExvs1ce6hbfHdaT7NvsYjG5Gl1_vZxPzq9HNqc5H3nvJDDLNa3QyUorx7XmaAuJ3pYowJYWqLM-9zgYSg-59RUCVJwLL704yT7uuds6tubwd61hmila5kLIQTHfK1yEtdmmsIF0ZyIEc1-IaWkgdcHWaLT3zJdKK2AsVz6vCqTWcYp-KCmBA-vz4bW-2qCzw_AJ6mfQ5zdNWJll_GkKynghxQD4dACkeNtj25lNaC3WNTQY-13fXGkty1z9h5QpXTCVl4P09C_pvz8i36tsim2b0D_2zajZRe_BZXbRM4foDbYPT2d-ND1kTfwBLFjYNg</recordid><startdate>20160901</startdate><enddate>20160901</enddate><creator>Ciappuccini, Renaud</creator><creator>Aide, Nicolas</creator><creator>Blanchard, David</creator><creator>Rame, Jean-Pierre</creator><creator>de Raucourt, Dominique</creator><creator>Michels, Jean-Jacques</creator><creator>Babin, Emmanuel</creator><creator>Bardet, Stéphane</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20160901</creationdate><title>Incremental Value of a Dedicated Head and Neck Acquisition during 18F-FDG PET/CT in Patients with Differentiated Thyroid Cancer</title><author>Ciappuccini, Renaud ; Aide, Nicolas ; Blanchard, David ; Rame, Jean-Pierre ; de Raucourt, Dominique ; Michels, Jean-Jacques ; Babin, Emmanuel ; Bardet, Stéphane</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4042-ffd6a1c280bed6b87d2882ec56efc9e3ac9ca0dcf4fe4049fa4cfbeaab223f6f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adenocarcinoma - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ciappuccini, Renaud</au><au>Aide, Nicolas</au><au>Blanchard, David</au><au>Rame, Jean-Pierre</au><au>de Raucourt, Dominique</au><au>Michels, Jean-Jacques</au><au>Babin, Emmanuel</au><au>Bardet, Stéphane</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incremental Value of a Dedicated Head and Neck Acquisition during 18F-FDG PET/CT in Patients with Differentiated Thyroid Cancer</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2016-09-01</date><risdate>2016</risdate><volume>11</volume><issue>9</issue><spage>e0162482</spage><epage>e0162482</epage><pages>e0162482-e0162482</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>18F-FDG-PET/CT is a useful tool used to evidence persistent/recurrent disease (PRD) in patients with differentiated thyroid cancer and iodine-refractory lesions. The aim of this study was to compare the diagnostic value at the cervical level of the routine whole-body (WB) acquisition and that of a complementary head and neck (HN) acquisition, performed successively during the same PET/CT study.
PET/CT studies combining WB and HN acquisitions performed in 85 consecutive patients were retrospectively reviewed by two nuclear medicine physicians. 18F-FDG uptake in cervical lymph nodes (LN) or in the thyroid bed was assessed. Among the 85 patients, the PET/CT results of the 26 who subsequently underwent neck surgery were compared with surgical and pathological reports. The size of each largest nodal metastasis was assessed by a pathologist.
In the 85 patients, inter-observer agreement was excellent for both WB and HN PET/CT interpretation. Of the 26 patients who underwent surgery, 25 had pathology proven PRD in the neck. Of these 25 patients, 15 displayed FDG uptake on either WB or HN PET. In these 15 patients, HN PET detected more malignant lesions than WB PET did (21/27 = 78% vs. 12/27 = 44%, P = 0.006). Node/background ratios were significantly higher on HN than on WB PET (P<0.0001). Three false-negative studies (20%) on WB PET were upstaged as true-positive on HN PET. The mean size of the largest LN metastasis was 3 mm for the LN detected neither on WB nor on HN PET, 7 mm for the metastasis detected on HN but not on WB PET, and 13 mm for those detected on both acquisitions (P = 0.0004). Receiver-Operating Characteristic analysis showed that area under the curve was higher for HN PET than for WB PET (0.97 [95%CI, 0.90-0.99] vs 0.88 [95%CI, 0.78-0.95], P = 0.009).
HN acquisition improves the ability to detect PRD in the neck compared with WB acquisition alone. We recommend systematically adding an HN acquisition when PET/CT is performed to detect PRD in the neck.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>27598385</pmid><doi>10.1371/journal.pone.0162482</doi><oa>free_for_read</oa></addata></record> |
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| issn | 1932-6203 1932-6203 |
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| recordid | cdi_plos_journals_1817094336 |
| source | Publicly Available Content (ProQuest); PubMed Central |
| subjects | Adenocarcinoma - diagnostic imaging Adenocarcinoma - metabolism Adenocarcinoma - pathology Adenocarcinoma - surgery Adult Aged Algorithms Area Under Curve Biology and Life Sciences Cancer Diagnostic systems Female Fluorodeoxyglucose F18 - pharmacokinetics Humans Iodine Lesions Lymph nodes Lymphatic Metastasis Male Medical imaging Medical personnel Medicine and Health Sciences Metastases Metastasis Middle Aged Neck Neoplasm Recurrence, Local - diagnostic imaging Neoplasm Recurrence, Local - metabolism Neoplasm Recurrence, Local - pathology Neoplasm Recurrence, Local - surgery Nuclear medicine Observer Variation Pathology Patients Physicians Positron emission Positron emission tomography Positron Emission Tomography Computed Tomography Radiopharmaceuticals - pharmacokinetics Research and Analysis Methods Retrospective Studies ROC Curve Surgery Surgical instruments Thyroid Thyroid cancer Thyroid Neoplasms - diagnostic imaging Thyroid Neoplasms - metabolism Thyroid Neoplasms - pathology Thyroid Neoplasms - surgery Tomography Ultrasonic imaging |
| title | Incremental Value of a Dedicated Head and Neck Acquisition during 18F-FDG PET/CT in Patients with Differentiated Thyroid Cancer |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-02T19%3A51%3A04IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Incremental%20Value%20of%20a%20Dedicated%20Head%20and%20Neck%20Acquisition%20during%2018F-FDG%20PET/CT%20in%20Patients%20with%20Differentiated%20Thyroid%20Cancer&rft.jtitle=PloS%20one&rft.au=Ciappuccini,%20Renaud&rft.date=2016-09-01&rft.volume=11&rft.issue=9&rft.spage=e0162482&rft.epage=e0162482&rft.pages=e0162482-e0162482&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0162482&rft_dat=%3Cproquest_plos_%3E4172597751%3C/proquest_plos_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c4042-ffd6a1c280bed6b87d2882ec56efc9e3ac9ca0dcf4fe4049fa4cfbeaab223f6f3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1817094336&rft_id=info:pmid/27598385&rfr_iscdi=true |