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The Effects of TSH level on the Results of F-18 FDG PET/CT in Recurrent Differentiated Thyroid Carcinoma Patients with Elevated Serum Thyroglobulin Level and Negative I-131 WBS.

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Last updated: 03 Jan 2025

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Abstract

Purpose : To assess the effects of TSH level on F-18 FDG PET-CT results & its impact on serum thyroglobulin (TG) cut off point and management in recurrent DTC patients with elevated TG level & negative I-131 WBS. Material
and Methods: This prospective work involved 38 histopathologically proved DTC patients underwent total thyroid ablation with elevated serum TG and negative I-131 WBS during follow up. F-18 FDG was done in all patients using standard technique. Results: Patients divided into two groups: (I) Stimulated TSH group (i.e. TSH level > 30 IU/L, 60 ± 20 IU/L): 20 patients. (II) Suppressed TSH group (i.e. TSH level <0.1 IU/L, 0.007 ± 0.003IU/L): 18 patients. Significantly higher overall accuracy, sensitivity & NPV were found in stimulated group (98.5%, 88.6%, 62% respectively) compared to the suppressed group (66%, 62% & 31.5% respectively) that was more obvious in nodal rather than pulmonary deposits (P<0.05). However no significant difference was demonstrated in specificity & PPV between both groups. Significantly lower TG cut off point was demonstrated in stimulated group (15 ng/ml) compared to suppressed group (21 ng/ml) (P<0.05). Moreover significantly higher impact of F-18 FDG PET-CT in TSH stimulated (40%) was demonstrated compared to TSH suppressed (11.2%) group on patient management.
Conclusion: High TSH seems to enhance F-18 FDG PET/CT efficiency on nodal rather than pulmonary metastases in recurrent DTC patients with elevated serum TG level and negative I-131 WBS. Moreover it reduces TG cut off point for F-18 FDG PET-CT & escalates its impact on patient management.

DOI

10.21608/egyjnm.2012.5475

Keywords

FDG PET/CT, TSH, De-DTC

Authors

First Name

Magdy

Last Name

Kotb

MiddleName

-

Affiliation

National Cancer Institute , Cairo University

Email

mag_kotb@yahoo.com

City

-

Orcid

-

Volume

6

Article Issue

6

Related Issue

949

Issue Date

2012-12-01

Receive Date

2018-02-21

Publish Date

2012-12-01

Page Start

40

Page End

54

Print ISSN

1687-4994

Online ISSN

2536-9113

Article File

EGYJNM_Volume 6_Issue 6_Pages 40-54.pdf

PDF . 249.3kB

Link

https://egyjnm.journals.ekb.eg/article_5475.html

Detail API

https://egyjnm.journals.ekb.eg/service?article_code=5475

Order

5

Type

Original Paper, Oncology

Type Code

380

Publication Type

Journal

Publication Title

Egyptian Journal Nuclear Medicine

Publication Link

https://egyjnm.journals.ekb.eg/

MainTitle

The Effects of TSH level on the Results of F-18 FDG PET/CT in Recurrent Differentiated Thyroid Carcinoma Patients with Elevated Serum Thyroglobulin Level and Negative I-131 WBS.

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Article

Created At

22 Jan 2023