Skip to main content

Advertisement

SpringerLink
Log in

18F-fluorodeoxyglucose positron emission tomography and computed tomography in anaplastic thyroid cancer

  • Original Article
  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Gilliland FD, Hunt WC, Morris DM, Key CR. Prognostic factors for thyroid carcinoma. A population-based study of 15,698 cases from the Surveillance, Epidemiology and End Results (SEER) program 1973–1991. Cancer 1997;79:564–73.

    Article  CAS  PubMed  Google Scholar 

  2. Ain KB. Anaplastic thyroid carcinoma: behavior, biology, and therapeutic approaches. Thyroid 1998;8:715–26.

    Article  CAS  PubMed  Google Scholar 

  3. Pasieka JL. Anaplastic thyroid cancer. Curr Opin Oncol 2003;15:78–83.

    Article  PubMed  Google Scholar 

  4. O’Neill JP, O’Neill B, Condron C, Walsh M, Bouchier-Hayes D. Anaplastic (undifferentiated) thyroid cancer: improved insight and therapeutic strategy into a highly aggressive disease. J Laryngol Otol 2005;119:585–91.

    PubMed  Google Scholar 

  5. Are C, Shaha AR. Anaplastic thyroid carcinoma: biology, pathogenesis, prognostic factors, and treatment approaches. Ann Surg Oncol 2006;13:453–64.

    Article  PubMed  Google Scholar 

  6. Cornett WR, Sharma AK, Day TA, Richardson MS, Hoda RS, van Heerden JA, et al. Anaplastic thyroid carcinoma: an overview. Curr Oncol Rep 2007;9:152–8.

    Article  PubMed  Google Scholar 

  7. Kebebew E, Greenspan FS, Clark OH, Woeber KA, McMillan A. Anaplastic thyroid carcinoma. Treatment outcome and prognostic factors. Cancer 2005;103:1330–5.

    Article  PubMed  Google Scholar 

  8. Venkatesh YS, Ordonez NG, Schultz PN, Hickey RC, Goepfert H, Samaan NA. Anaplastic carcinoma of the thyroid. A clinicopathologic study of 121 cases. Cancer 1990;66:321–30.

    Article  CAS  PubMed  Google Scholar 

  9. Schlumberger M, Parmentier C, Delisle MJ, Couette JE, Droz JP, Sarrazin D. Combination therapy for anaplastic giant cell thyroid carcinoma. Cancer 1991;67:564–6.

    Article  CAS  PubMed  Google Scholar 

  10. Demeter JG, De Jong SA, Lawrence AM, Paloyan E. Anaplastic thyroid carcinoma: risk factors and outcome. Surgery 1991;110:956–61. discussion 961–3.

    CAS  PubMed  Google Scholar 

  11. Tan RK, Finley 3rd RK, Driscoll D, Bakamjian V, Hicks Jr WL, Shedd DP. Anaplastic carcinoma of the thyroid: a 24-year experience. Head Neck 1995;17:41–7. discussion 47–8.

    Article  CAS  PubMed  Google Scholar 

  12. Nilsson O, Lindeberg J, Zedenius J, Ekman E, Tennvall J, Blomgren H, et al. Anaplastic giant cell carcinoma of the thyroid gland: treatment and survival over a 25-year period. World J Surg 1998;22:725–30.

    Article  CAS  PubMed  Google Scholar 

  13. Passler C, Scheuba C, Prager G, Kaserer K, Flores JA, Vierhapper H, et al. Anaplastic (undifferentiated) thyroid carcinoma (ATC). A retrospective analysis. Langenbecks Arch Surg 1999;384:284–93.

    Article  CAS  PubMed  Google Scholar 

  14. Besic N, Auersperg M, Us-Krasovec M, Golouh R, Frkovic-Grazio S, Vodnik A. Effect of primary treatment on survival in anaplastic thyroid carcinoma. Eur J Surg Oncol 2001;27:260–4.

    Article  CAS  PubMed  Google Scholar 

  15. Sugitani I, Kasai N, Fujimoto Y, Yanagisawa A. Prognostic factors and therapeutic strategy for anaplastic carcinoma of the thyroid. World J Surg 2001;25:617–22.

    Article  CAS  PubMed  Google Scholar 

  16. Haigh PI, Ituarte PH, Wu HS, Treseler PA, Posner MD, Quivey JM, et al. Completely resected anaplastic thyroid carcinoma combined with adjuvant chemotherapy and irradiation is associated with prolonged survival. Cancer 2001;91:2335–42.

    Article  CAS  PubMed  Google Scholar 

  17. McIver B, Hay ID, Giuffrida DF, Dvorak CE, Grant CS, Thompson GB, et al. Anaplastic thyroid carcinoma: a 50-year experience at a single institution. Surgery 2001;130:1028–34.

    Article  CAS  PubMed  Google Scholar 

  18. De Crevoisier R, Baudin E, Bachelot A, Leboulleux S, Travagli JP, Caillou B, et al. Combined treatment of anaplastic thyroid carcinoma with surgery, chemotherapy, and hyperfractionated accelerated external radiotherapy. Int J Radiat Oncol Biol Phys 2004;60:1137–43.

    PubMed  Google Scholar 

  19. Goutsouliak V, Hay JH. Anaplastic thyroid cancer in British Columbia 1985–1999: a population-based study. Clin Oncol (R Coll Radiol) 2005;17:75–8.

    CAS  Google Scholar 

  20. Besic N, Hocevar M, Zgajnar J, Pogacnik A, Grazio-Frkovic S, Auersperg M. Prognostic factors in anaplastic carcinoma of the thyroid-a multivariate survival analysis of 188 patients. Langenbecks Arch Surg 2005;390:203–8.

    Article  PubMed  Google Scholar 

  21. Kim TY, Kim KW, Jung TS, Kim JM, Kim SW, Chung KW, et al. Prognostic factors for Korean patients with anaplastic thyroid carcinoma. Head Neck 2007;29:765–72.

    Article  PubMed  Google Scholar 

  22. Pacheco-Ojeda LA, Martínez AL, Alvarez M. Anaplastic thyroid carcinoma in Ecuador: analysis of prognostic factors. Int Surg 2001;86:117–21.

    CAS  PubMed  Google Scholar 

  23. Bogsrud TV, Karantanis D, Nathan MA, Mullan BP, Wiseman GA, Kasperbauer JL, et al. 18F-FDG PET in the management of patients with anaplastic thyroid carcinoma. Thyroid 2008;18:713–9.

    Article  CAS  PubMed  Google Scholar 

  24. Jadvar H, Fischman AJ. Evaluation of rare tumors with [F-18]fluorodeoxyglucose positron emission tomography. Clin Positron Imaging 1999;2:153–8.

    Article  PubMed  Google Scholar 

  25. Poppe K, Lahoutte T, Everaert H, Bossuyt A, Velkeniers B. The utility of multimodality imaging in anaplastic thyroid carcinoma. Thyroid 2004;14:981–2.

    Article  PubMed  Google Scholar 

  26. Khan N, Oriuchi N, Higuchi T, Endo K. Review of fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in the follow-up of medullary and anaplastic thyroid carcinomas. Cancer Control 2005;12:254–60.

    PubMed  Google Scholar 

  27. Iagaru A, McDougall IR. F-18 FDG PET/CT demonstration of an adrenal metastasis in a patient with anaplastic thyroid cancer. Clin Nucl Med 2007;32:13–5.

    Article  PubMed  Google Scholar 

  28. Nguyen BD, Ram PC. PET/CT staging and posttherapeutic monitoring of anaplastic thyroid carcinoma. Clin Nucl Med 2007;32:145–9.

    Article  PubMed  Google Scholar 

  29. Robbins RJ, Wan Q, Grewal RK, Reibke R, Gonen M, Strauss HW, et al. Real-time prognosis for metastatic thyroid carcinoma based on 2-[18F]fluoro-2-deoxy-D-glucose-positron emission tomography scanning. J Clin Endocrinol Metab 2006;91:498–505.

    Article  CAS  PubMed  Google Scholar 

  30. Leboulleux S, Schroeder PR, Schlumberger M, Ladenson PW. The role of PET in follow-up of patients treated for differentiated epithelial thyroid cancers. Nat Clin Pract Endocrinol Metab 2007;3:112–21.

    Article  PubMed  Google Scholar 

  31. Leboulleux S, Dromain C, Bonniaud G, Aupérin A, Caillou B, Lumbroso J, et al. Diagnostic and prognostic value of 18-fluorodeoxyglucose positron emission tomography in adrenocortical carcinoma: a prospective comparison with computed tomography. J Clin Endocrinol Metab 2006;91:920–5.

    Article  CAS  PubMed  Google Scholar 

  32. Young H, Baum R, Cremerius U, Herholz K, Hoekstra O, Lammertsma AA, et al. Measurement of clinical and subclinical tumour response using [18F]-fluorodeoxyglucose and positron emission tomography: review and 1999 EORTC recommendations. European Organization for Research and Treatment of Cancer (EORTC) PET Study Group. Eur J Cancer 1999;35:1773–82.

    Article  CAS  PubMed  Google Scholar 

  33. Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 2000;92:205–16.

    Article  CAS  PubMed  Google Scholar 

  34. Obuchowski NA. On the comparison of correlated proportions for clustered data. Stat Med 1998;17:1495–507.

    Article  CAS  PubMed  Google Scholar 

  35. Wang W, Larson SM, Fazzari M, Tickoo SK, Kolbert K, Sgouros G, et al. Prognostic value of [18F]fluorodeoxyglucose positron emission tomographic scanning in patients with thyroid cancer. J Clin Endocrinol Metab 2000;85:1107–13.

    Article  CAS  PubMed  Google Scholar 

  36. Rivera M, Ghossein RA, Schoder H, Gomez D, Larson SM, Tuttle RM. Histopathologic characterization of radioactive iodine-refractory fluorodeoxyglucose-positron emission tomography-positive thyroid carcinoma. Cancer 2008;113:48–56.

    Article  PubMed  Google Scholar 

  37. Ben-Haim S, Ell P. 18F-FDG PET and PET/CT in the evaluation of cancer treatment response. J Nucl Med 2009;50:88–99.

    Article  PubMed  Google Scholar 

  38. Decoster L, Schallier D, Everaert H, Nieboer K, Meysman M, Neyns B, et al. Complete metabolic tumour response, assessed by 18-fluorodeoxyglucose positron emission tomography (18FDG-PET), after induction chemotherapy predicts a favourable outcome in patients with locally advanced non-small cell lung cancer (NSCLC). Lung Cancer 2008;62:55–61.

    Article  CAS  PubMed  Google Scholar 

  39. Connell CA, Corry J, Milner AD, Hogg A, Hicks RJ, Rischin D, et al. Clinical impact of, and prognostic stratification by, F-18 FDG PET/CT in head and neck mucosal squamous cell carcinoma. Head Neck 2007;29:986–95.

    Article  PubMed  Google Scholar 

  40. Kim MK, Ryu JS, Kim SB, Ahn JH, Kim SY, Park SI, et al. Value of complete metabolic response by (18)F-fluorodeoxyglucose-positron emission tomography in oesophageal cancer for prediction of pathologic response and survival after preoperative chemoradiotherapy. Eur J Cancer 2007;43:1385–91.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was partially supported by the Programme Hospitalier de Recherche Clinique 2002, AOM 02 118.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy and University Paris-Sud XI, 94805, Villejuif Cedex, France

    Thomas Poisson, Désirée Deandreis, Sophie Leboulleux, Jean Lumbroso, Eric Baudin & Martin Schlumberger

  2. Department of Radiology, Institut Gustave Roussy and University Paris-Sud XI, 94805, Villejuif Cedex, France

    François Bidault

  3. Department of Medical Physics, Institut Gustave Roussy and University Paris-Sud XI, 94805, Villejuif Cedex, France

    Guillaume Bonniaud

  4. Department of Epidemiology, Institut Gustave Roussy and University Paris-Sud XI, 94805, Villejuif Cedex, France

    Sylvain Baillot & Anne Aupérin

  5. Department of Pathology, Institut Gustave Roussy and University Paris-Sud XI, 94805, Villejuif Cedex, France

    Abir Al Ghuzlan

  6. Department of Endocrine Surgery, Institut Gustave Roussy and University Paris-Sud XI, 94805, Villejuif Cedex, France

    Jean-Paul Travagli

  7. Service de Médecine Nucléaire et de Cancérologie Endocrinienne, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94800, Villejuif, France

    Martin Schlumberger

  8. Service de Médecine Nucléaire, Hôpital Bichat, 46 rue Henri Huchard, 75018, Paris, France

    Thomas Poisson

Authors
  1. Thomas Poisson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Désirée Deandreis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sophie Leboulleux
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. François Bidault
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Guillaume Bonniaud
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sylvain Baillot
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Anne Aupérin
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Abir Al Ghuzlan
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jean-Paul Travagli
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Jean Lumbroso
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Eric Baudin
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Martin Schlumberger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Martin Schlumberger.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Poisson, T., Deandreis, D., Leboulleux, S. et al. 18F-fluorodeoxyglucose positron emission tomography and computed tomography in anaplastic thyroid cancer. Eur J Nucl Med Mol Imaging 37, 2277–2285 (2010). https://doi.org/10.1007/s00259-010-1570-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-010-1570-6

Keywords

Search

Navigation