18F-fluorodeoxyglucose positron emission tomography and computed tomography in anaplastic thyroid cancer
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Our aim was to evaluate in anaplastic thyroid carcinoma (ATC) patients the value of 18F-FDG PET/CT compared with total body computed tomography (CT) using intravenous contrast material for initial staging, prognostic assessment, therapeutic monitoring and follow-up.
Twenty consecutive ATC patients underwent PET/CT for initial staging. PET/CT was performed again during follow-up. The gold standard was progression on imaging follow-up (CT or PET/CT) or confirmation with another imaging modality.
A total of 265 lesions in 63 organs were depicted in 18 patients. Thirty-five per cent of involved organs were demonstrated only with PET/CT and one involved organ only with CT. In three patients, the extent of disease was significantly changed with PET/CT that demonstrated unknown metastases. Initial treatment modalities were modified by PET/CT findings in 25% of cases. The volume of FDG uptake (≥300 ml) and the intensity of FDG uptake (SUVmax ≥18) were significant prognostic factors for survival. PET/CT permitted an earlier assessment of tumour response to treatment than CT in 4 of the 11 patients in whom both examinations were performed. After treatment with combined radiotherapy and chemotherapy, only the two patients with a negative control PET/CT had a confirmed complete remission at 14 and 38 months; all eight patients who had persistent FDG uptake during treatment had a clinical recurrence and died.
FDG PET/CT appears to be the reference imaging modality for ATC at initial staging and seems promising in the early evaluation of treatment response and follow-up.
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- 18F-fluorodeoxyglucose positron emission tomography and computed tomography in anaplastic thyroid cancer
European Journal of Nuclear Medicine and Molecular Imaging
Volume 37, Issue 12 , pp 2277-2285
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- Anaplastic thyroid carcinoma
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- 1. Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy and University Paris-Sud XI, 94805, Villejuif Cedex, France
- 8. Service de Médecine Nucléaire, Hôpital Bichat, 46 rue Henri Huchard, 75018, Paris, France
- 2. Department of Radiology, Institut Gustave Roussy and University Paris-Sud XI, 94805, Villejuif Cedex, France
- 3. Department of Medical Physics, Institut Gustave Roussy and University Paris-Sud XI, 94805, Villejuif Cedex, France
- 4. Department of Epidemiology, Institut Gustave Roussy and University Paris-Sud XI, 94805, Villejuif Cedex, France
- 5. Department of Pathology, Institut Gustave Roussy and University Paris-Sud XI, 94805, Villejuif Cedex, France
- 6. Department of Endocrine Surgery, Institut Gustave Roussy and University Paris-Sud XI, 94805, Villejuif Cedex, France
- 7. Service de Médecine Nucléaire et de Cancérologie Endocrinienne, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94800, Villejuif, France