Abstract
BackgroundPositron emission tomography (PET) with fluor-18-deoxy-glucose (FDG) is widely used for diagnosing recurrent or metastatic disease in patients with differentiated thyroid cancer (DTC).PurposeTo assess the diagnostic accuracy of FDG-PET for DTC in patients after ablative therapy.Material and MethodsA systematic search was conducted in Medline/PubMed, EMBASE, Cochrane Library, Web of Science, and Open Grey looking for all English-language original articles on the performance of FDG-PET in series of at least 20 patients with DTC having undergone ablative therapy including total thyroidectomy. Diagnostic performance measures were pooled using Reitsma’s bivariate model.ResultsThirty-four publications between 1996 and 2014 met the inclusion criteria. Pooled sensitivity and specificity were 79.4% (95% confidence interval [CI], 73.9–84.1) and 79.4% (95% CI, 71.2–85.4), respectively, with an area under the curve of 0.858.ConclusionF18-FDG-PET is a useful method for detecting recurrent DTC in patients having undergone ablative therapy.
Highlights
Differentiated thyroid cancer (DTC) is the most common malignant endocrine tumor
Routine ultrasound of the neck is often negative in these patients, as we recently demonstrated in a prospective cohort from our institution [2]
Our selection criteria were: (i) all patients had undergone previous ablative therapy including total thyroidectomy; (ii) patients were suspected of having recurrences and/or metastases or had risk factors such as a measurable or rising human thyroglobulin (hTg) or circulating hTg antibodies; (iii) patients underwent an FDG-Positron emission tomography (PET) or combined hybrid FDG-PET/computed tomography (CT) of the torso; (iv) reported study data were sufficient to calculate sensitivity and specificity for tumor detection; (v) histology, cytology, or follow-up were used as gold standard
Summary
Differentiated thyroid cancer (DTC) is the most common malignant endocrine tumor. prognosis is generally favorable, with reported 5-year survival rates of 95% for women and 87% for men [1], some patients continue to experience adverse outcomes despite improvements in imaging and surgical technique [2,3].Serum human thyroglobulin (hTg) is a reliable marker for persistent or recurrent disease after previous ablative therapy with total thyroidectomy with or without additional ablative radioiodine therapy (RIT). Differentiated thyroid cancer (DTC) is the most common malignant endocrine tumor. In two seminal papers in 1995 and 1996, Feine et al demonstrated that positron emission tomography (PET) with fluor18-deoxy-glucose (FDG) can detect tumor lesions that. Positron emission tomography (PET) with fluor-18-deoxy-glucose (FDG) is widely used for diagnosing recurrent or metastatic disease in patients with differentiated thyroid cancer (DTC). Purpose: To assess the diagnostic accuracy of FDG-PET for DTC in patients after ablative therapy. Material and Methods: A systematic search was conducted in Medline/PubMed, EMBASE, Cochrane Library, Web of Science, and Open Grey looking for all English-language original articles on the performance of FDG-PET in series of at least 20 patients with DTC having undergone ablative therapy including total thyroidectomy. Conclusion: F18-FDG-PET is a useful method for detecting recurrent DTC in patients having undergone ablative therapy
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