Filippi Luca, Frantellizzi Viviana, Monari Fabio, Lodi Rizzini Elisa, Tabacchi Elena, Pirisino Riccardo, Marongiu Andrea, Nuvoli Susanna, Bagni Oreste, De Vincentis Giuseppe, Schillaci Orazio, Spanu Angela
Nuclear Medicine Unit, "Santa Maria Goretti" Hospital, Via Antonio Canova, 04100 Latina, Italy.
Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Viale Regina Elena 324, 00100 Rome, Italy.
Diagnostics (Basel). 2021 Jul 14;11(7):1264. doi: 10.3390/diagnostics11071264.
our aim was to assess the diagnostic performance and clinical impact of F-FDG PET/CT in patients with differentiated thyroid carcinoma (DTC), previously treated with surgery and radioiodine therapy (RAI).
patients subjected to F-FDG PET/CT for suspected DTC recurrence in three Italian nuclear medicine units were evaluated. Two different clinical settings were identified: clinical setting 1 included patients (n = 40) that were enrolled according to the American Thyroid Association guidelines (i.e., negative 1-WBS and Tg level > 10 ng/mL); and clinical setting 2, that encompassed subjects (n = 26) with serum Tg ≤ 10 ng/mL but morphological findings suspected of relapse. PET/CT's impact was scored as significant if it provided an indication for surgery, or led to a novel therapeutic decision.
In total, 51/66 patients (77.3%) were F-FDG positive, while 15 (22.7%) were negative. PET/CT showed an overall sensitivity and specificity of 84.4% and 75%, respectively. Sensitivity was higher in clinical setting 1 (89.1%) as compared to clinical setting 2 (76.1%), although this difference was not statistically significant ( = 0.83). PET/CT influenced clinical management in 28 cases (42.4%), without a significant difference between the 2 groups of patients ( = 0.6).
our preliminary data, although limited by the retrospective nature of the study and possible selection bias, suggest that F-FDG PET/CT may be utilized for the detection of DTC recurrence in different clinical settings, with a meaningful impact on clinical management.
我们的目的是评估氟代脱氧葡萄糖正电子发射断层显像/计算机断层扫描（F-FDG PET/CT）在先前接受过手术和放射性碘治疗（RAI）的分化型甲状腺癌（DTC）患者中的诊断性能及临床影响。
对在三个意大利核医学科室因怀疑DTC复发而接受F-FDG PET/CT检查的患者进行评估。确定了两种不同的临床情况：临床情况1包括根据美国甲状腺协会指南入组的患者（n = 40）（即1-全身碘扫描阴性且甲状腺球蛋白（Tg）水平> 10 ng/mL）；临床情况2包括血清Tg≤10 ng/mL但有形态学表现怀疑复发的受试者（n = 26）。如果PET/CT为手术提供了指征或导致了新的治疗决策，则将其影响评为显著。
总共66例患者中有51例（77.3%）F-FDG呈阳性，而15例（22.7%）为阴性。PET/CT的总体敏感性和特异性分别为84.4%和75%。临床情况1中的敏感性（89.1%）高于临床情况2（76.1%），尽管这种差异无统计学意义（P = 0.83）。PET/CT在28例（42.4%）患者中影响了临床管理，两组患者之间无显著差异（P = 0.6）。
我们的初步数据虽然受研究的回顾性性质和可能的选择偏倚限制，但表明F-FDG PET/CT可用于在不同临床情况下检测DTC复发，对临床管理有重要影响。
