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Detection of neck recurrence in patients with differentiated thyroid cancer: comparison of ultrasound, contrast-enhanced CT and 18F-FDG PET/CT using surgical pathology as a reference standard: (ultrasound vs. CT vs. 18F-FDG PET/CT in recurrent thyroid cancer)

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Abstract

Objectives

To compare the diagnostic performance of ultrasound, contrast-enhanced computed tomography (CT) and 18F-FDG positron emission tomography (PET)/CT for detecting recurrent differentiated thyroid cancer in the neck.

Methods

Twenty patients who had undergone previous surgery for differentiated thyroid cancer (19 papillary carcinomas; 1 medullary carcinoma) and presented with pathologically proven recurrence in the neck were included. All patients had undergone ultrasound, CT and PET/CT in the 2 months before further surgery. In each patient, ultrasound, CT and PET/CT images were retrospectively reviewed to determine the presence of loco-regional recurrence by level-by-level analysis. Imaging results were correlated with the histological evaluation of the neck dissection as a standard of reference.

Results

Recurrences were found at 52 out of 110 cervical nodal levels surgically explored. The sensitivity, specificity and accuracy were 69.2 %, 89.7 % and 80.0 % for ultrasound; 63.5 %, 94.8 % and 80.0 % for CT; and 53.8 %, 79.3 % and 67.3 % for PET/CT, respectively. ROC analysis revealed higher diagnostic performance with ultrasound than with PET/CT for detecting recurrent tumour.

Conclusions

Although no significant difference was found among the three techniques, the sensitivity and specificity of ultrasound and CT were higher than those of PET/CT for the evaluation of cervical recurrence in patients with differentiated thyroid cancer.

Key Points

• Ultrasound, CT and 18 F-FDG PET/CT can all detect recurrent thyroid cancer.

• Ultrasound and CT have higher sensitivity and specificity.

• Ultrasound, CT and 18 F-FDG PET/CT frequently demonstrated discordant findings

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Authors and Affiliations

  1. Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, 445 Gil-dong, Kangdong-gu, Seoul, 134-701, Korea

    Young Lan Seo, Dae Young Yoon & You Jin Ku

  2. Department of Nuclear Medicine, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, 445 Gil-dong, Kangdong-gu, Seoul, 134-701, Korea

    Sora Baek

  3. Department of Otorhinolaryngology, Ilsong Memorial Institute of Head and Neck Cancer, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, 445 Gil-dong, Kangdong-gu, Seoul, 134-701, Korea

    Young-Soo Rho & Eun-Jae Chung

  4. Department of Radiology, Hallym University College of Medicine, Hallym University Sacred Heart Hospital, 896, Pyungchon-dong, Dongan-gu, Anyang, Gyonggi-do, 431-070, Korea

    Sung Hye Koh

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  1. Young Lan Seo
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  2. Dae Young Yoon
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Correspondence to Dae Young Yoon.

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Seo, Y.L., Yoon, D.Y., Baek, S. et al. Detection of neck recurrence in patients with differentiated thyroid cancer: comparison of ultrasound, contrast-enhanced CT and 18F-FDG PET/CT using surgical pathology as a reference standard: (ultrasound vs. CT vs. 18F-FDG PET/CT in recurrent thyroid cancer). Eur Radiol 22, 2246–2254 (2012). https://doi.org/10.1007/s00330-012-2470-x

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  • DOI: https://doi.org/10.1007/s00330-012-2470-x

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