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140414

Value of Initial 18F-FDG PET/CT in Change of Management of Patients with Differentiated Thyroid Cancer as Compared to Post Ablative Whole Body Iodine Scan.

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Last updated: 03 Jan 2025

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Abstract

Differentiated thyroid cancers (DTC) are generally malignant endocrine tumors with good prognosis. 50-68% of patients with DTC's have local or regional recurrences depending on the patient's risk factors. The aim of the work: was to assess the rule of initial PET/CT in patients with DTC, evaluate the PET/CT as compared to post ablative WBS in DTC. The study included 124 patients with essentially pathologically proven differentiated cancer thyroid patients who had undergone or near total thyroidectomy and was eligible for RAI ablative dose. Pathological details, TG levels and post ablative I-131 WBS results were also reviewed and compared to PET/CT results. A short follow up period ranged from 4-6 months was used as a reference to validate the results of the current study. Results: we found the majority were females (74.2%), The mean age was 42 years old, papillary thyroid cancer was the dominant type in (83.1 %). (55.6%) was of low risk according to ATA Risk stratification and of stage I, Serum TG levels varied widely from 0.04-13564 with a median value of 8.28 ng/ml. 38 patients out of 124 (30.6%) showed positive FDG uptake in following sites thyroid operative bed, cervical and mediastinal LNs, pulmonary and bone metastases with the majority of pathological FDG uptake being at the loco-regional area in 38 patients. It was observed that PET/CT had positive results in older age groups especially those above 50 years old, patients with elevated serum TG levels with a median value of 40 ng/ml, Hurthle cell type and Intermediate /High risk groups. Therefore, patients with such criteria are more likely to benefit from initial PET/CT prior to their RAI dose. No significant correlation between the metabolic parameters and the avidity of RAI-131 positive findings was found. In 38 patients positive PET/CT results led to re-staging of 12 patients (9.6 %) and changed the management in 30 patients (24.2%). Conclusions: PET/CT changed the management in around 25 % of Differentiated thyroid cancers (DTC) that helped in validating the "Theranostics" concept which aimed at individualized patient management to achieve the best outcome.

DOI

10.21608/egyjnm.2020.140414

Keywords

Thyroid carcinoma, F-18 FDG PET/CT, Change in Management

Authors

First Name

Maamoun,

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Affiliation

Nuclear Medicine Unit, National Cancer Institute, Egypt.

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First Name

Moustafa,

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Affiliation

Nuclear Medicine Unit, Faculty of Medicine, Cairo University, Cairo, Egypt.

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First Name

Zaher,

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A

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Affiliation

Nuclear Medicine Unit, National Cancer Institute, Egypt.

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First Name

Fathy,

Last Name

H

MiddleName

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Affiliation

Nuclear Medicine Unit, National Cancer Institute, Egypt.

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Volume

21

Article Issue

2

Related Issue

20775

Issue Date

2020-12-01

Receive Date

2021-01-17

Publish Date

2020-12-01

Page Start

34

Page End

49

Print ISSN

1687-4994

Online ISSN

2536-9113

Link

https://egyjnm.journals.ekb.eg/article_140414.html

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https://egyjnm.journals.ekb.eg/service?article_code=140414

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4

Type

Original Paper, PET/CT

Type Code

379

Publication Type

Journal

Publication Title

Egyptian Journal Nuclear Medicine

Publication Link

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

MainTitle

Value of Initial 18F-FDG PET/CT in Change of Management of Patients with Differentiated Thyroid Cancer as Compared to Post Ablative Whole Body Iodine Scan.

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Article

Created At

22 Jan 2023