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Diagnostic value of 18F-FDG PET/CT in patients with TENIS syndrome: correlation with thyroglobulin levels

Abstract

Objective

The aim of the study was to disclose the place of 18F-FDG PET/CT to predict recurrent disease in patients with differentiated thyroid cancer (DTC), negative radioiodine whole-body scan (WBS) and high serum thyroglobulin (Tg).

Methods

Seventy-one patients who underwent total thyroidectomy followed by radioactive iodine ablation and had negative radioiodine WBS but elevated Tg levels underwent PET/CT. They were followed up for 6–50 months (median 23) for the occurence of recurrent disease as detected by either clinical findings, other imaging modalities or histopathological examination. The place of PET/CT findings at baseline to predict the presence of recurrent disease was evaluated. Correlation between PET/CT findings and Tg levels was examined and a threshold for Tg level above which the predictive value of PET/CT was highest was determined.

Results

PET/CT was positive for recurrent disease in 38 (53.5 %) patients. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of PET/CT to predict the occurence of recurrent disease at follow-up were 68.8, 78.3, 86.8, 54.5 and 71.9 %, respectively. The sensitivity, accuracy and PPV of PET/CT increased with increasing Tg levels. The highest diagnostic accuracy of PET/CT, with a sensitivity of 76.2 % and a specificity of 100 % to detect recurrent disease appeared to be at a Tg level greater than 29 ng/mL.

Conclusion

Our findings suggest that 18F-FDG-PET/CT is a valuable tool to predict the occurence of recurrent disease in patients with DTC, negative WBS and elevated Tg levels. PET/CT positivity has been shown to be strongly and positively correlated with Tg levels in this patient subset.

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Correspondence to Elif Özdemir.

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Özdemir, E., Yildirim Poyraz, N., Polat, S.B. et al. Diagnostic value of 18F-FDG PET/CT in patients with TENIS syndrome: correlation with thyroglobulin levels. Ann Nucl Med 28, 241–247 (2014). https://doi.org/10.1007/s12149-013-0801-x

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Keywords

  • 18F-FDG-PET/CT
  • Thyroglobulin
  • Differentiated thyroid cancer
  • Radioiodine imaging