F-18 FDG PET in Insular Thyroid Cancer

PURPOSEInsular thyroid cancer (ITC) is known to be a rare subtype of follicular thyroid carcinoma showing poor differentiation and an unfavorable prognosis. The authors evaluated the use of F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) for restaging and follow-up in ITC. METHODSFi...

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Bibliographic Details
Published in:Clinical nuclear medicine 2003-09, Vol.28 (9), p.728-731
Main Authors: Diehl, Michaela, Graichen, Sinikka, Menzel, Christian, Lindhorst, Elmar, Grünwald, Frank
Format: Article
Language:English
Subjects:
Adenocarcinoma, Follicular - diagnostic imaging
Adenocarcinoma, Follicular - therapy
Aged
Biological and medical sciences
Female
Fluorodeoxyglucose F18
Humans
Male
Medical sciences
Middle Aged
Neoplasm Staging
Radiopharmaceuticals
Retrospective Studies
Thyroid Neoplasms - diagnostic imaging
Thyroid Neoplasms - therapy
Tomography, Emission-Computed
Tomography, X-Ray Computed
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Summary:PURPOSEInsular thyroid cancer (ITC) is known to be a rare subtype of follicular thyroid carcinoma showing poor differentiation and an unfavorable prognosis. The authors evaluated the use of F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) for restaging and follow-up in ITC. METHODSFive patients (2 male, 3 female) with elevated thyroglobulin levels (mean, 86 ng/mL; range 1.3–180 ng/mL) during follow-up underwent FDG PET (Siemens ECAT Exact 47). PET results were correlated to histopathologic and radiologic findings as well as to the results of whole-body radioiodine scintigraphy. In 1 patient a series of 4 PET scans was done. RESULTSFDG PET showed a total of 10 tumor sites, at least 1 in each patient. Four of those lesions were detected by computed tomography (CT) as well, which in addition revealed 3 lesions that had normal glucose consumption. Five PET lesions were missed by the CT scan because they were found outside the examined volume of CT. Only 1 PET-positive lesion was also radioiodine positive. Three radioiodine-positive lesions with normal glucose metabolism were detected. CONCLUSIONAs known for well and poorly differentiated thyroid cancer of the follicular epithelium, ITC may also show discordance between radioiodine studies and FDG-positive lesions. Given their initially poor differentiation, the ITC clearly showed the expected dominance of less well-differentiated, FDG-positive lesions. Therefore, FDG PET seems to be a very useful tool for the staging and restaging of such tumors.
ISSN:0363-9762
1536-0229
DOI:10.1097/01.rlu.0000082658.78218.0f