FDG PET/CT in differentiated thyroid cancer patients with low thyroglobulin levels

Chantal A. Lebbink; Lisa H. de Vries; Inne H.M. Borel Rinkes; Arthur J.A.T. Braat; Rachel S. van Leeuwaarde; Lutske Lodewijk; Mark J.C. van Treijen; Menno R. Vriens; Gerlof D. Valk; Hanneke M. van Santen; Bart de Keizer

doi:10.1530/EJE-22-0072

FDG PET/CT in differentiated thyroid cancer patients with low thyroglobulin levels

Chantal A. Lebbink
, Lisa H. de Vries
, Inne H.M. Borel Rinkes
, Arthur J.A.T. Braat
, Rachel S. van Leeuwaarde
, Lutske Lodewijk
, Mark J.C. van Treijen
, Menno R. Vriens
, Gerlof D. Valk
, Hanneke M. van Santen
, Bart de Keizer

Group Tissing

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

Abstract

OBJECTIVE: To evaluate the usefulness of [18F]fluorodeoxyglucose (FDG) positron emissive tomography (PET)/CT in patients with low detectable thyroglobulin levels suspicious for persistent or recurrent differentiated thyroid cancer (DTC).

METHODS: A retrospective case series study evaluating FDG PET/CT in patients with detectable thyroglobulin (Tg) levels (≥0.20 and <10.00 ng/mL) after initial treatment with total thyroidectomy and I-131 thyroid remnant ablation for pT1-3aN0-1bM0 DTC. Sensitivity, specificity, positive (PPV) and negative predictive value (NPV) of FDG PET/CT were calculated.

RESULTS: Twenty-seven patients underwent FDG PET/CT. Median Tg level at FDG PET/CT was 2.00 ng/mL (range 0.30-9.00). FDG PET/CT was positive in 14 patients (51.9%): lesions suspicious for lymph node metastases were depicted in 12 patients, and lung metastases in 2. DTC was confirmed in 13/14 FDG PET/CT-positive patients. In 9/13 patients with a negative FDG PET/CT, DTC was confirmed ≤3 months after FDG PET/CT. The sensitivity, PPV, specificity and NPV were 59.1, 92.9, 80.0 and 30.8%, respectively.

CONCLUSIONS: This case series shows that FDG PET/CT might be useful to detect persistent or recurrent DTC in patients with low detectable Tg. However, when FDG PET/CT is negative, this does not rule out DTC and further investigations are necessary.

Original language	English
Pages (from-to)	101-110
Number of pages	10
Journal	European journal of endocrinology
Volume	187
Issue number	1
DOIs	https://doi.org/10.1530/EJE-22-0072
Publication status	Published - Jul 2022

Keywords

Adenocarcinoma
Fluorodeoxyglucose F18
Humans
Iodine Radioisotopes
Neoplasm Recurrence, Local/pathology
Positron Emission Tomography Computed Tomography
Positron-Emission Tomography
Retrospective Studies
Thyroglobulin
Thyroid Neoplasms/diagnostic imaging

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10.1530/EJE-22-0072

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Lebbink, C. A., de Vries, L. H., Borel Rinkes, I. H. M., Braat, A. J. A. T., van Leeuwaarde, R. S., Lodewijk, L., van Treijen, M. J. C., Vriens, M. R., Valk, G. D., van Santen, H. M., & de Keizer, B. (2022). FDG PET/CT in differentiated thyroid cancer patients with low thyroglobulin levels. European journal of endocrinology, 187(1), 101-110. https://doi.org/10.1530/EJE-22-0072

@article{997d8b7897b0492f8b9c2113a9f41efd,

title = "FDG PET/CT in differentiated thyroid cancer patients with low thyroglobulin levels",

abstract = "OBJECTIVE: To evaluate the usefulness of [18F]fluorodeoxyglucose (FDG) positron emissive tomography (PET)/CT in patients with low detectable thyroglobulin levels suspicious for persistent or recurrent differentiated thyroid cancer (DTC).METHODS: A retrospective case series study evaluating FDG PET/CT in patients with detectable thyroglobulin (Tg) levels (≥0.20 and <10.00 ng/mL) after initial treatment with total thyroidectomy and I-131 thyroid remnant ablation for pT1-3aN0-1bM0 DTC. Sensitivity, specificity, positive (PPV) and negative predictive value (NPV) of FDG PET/CT were calculated.RESULTS: Twenty-seven patients underwent FDG PET/CT. Median Tg level at FDG PET/CT was 2.00 ng/mL (range 0.30-9.00). FDG PET/CT was positive in 14 patients (51.9\%): lesions suspicious for lymph node metastases were depicted in 12 patients, and lung metastases in 2. DTC was confirmed in 13/14 FDG PET/CT-positive patients. In 9/13 patients with a negative FDG PET/CT, DTC was confirmed ≤3 months after FDG PET/CT. The sensitivity, PPV, specificity and NPV were 59.1, 92.9, 80.0 and 30.8\%, respectively.CONCLUSIONS: This case series shows that FDG PET/CT might be useful to detect persistent or recurrent DTC in patients with low detectable Tg. However, when FDG PET/CT is negative, this does not rule out DTC and further investigations are necessary.",

keywords = "Adenocarcinoma, Fluorodeoxyglucose F18, Humans, Iodine Radioisotopes, Neoplasm Recurrence, Local/pathology, Positron Emission Tomography Computed Tomography, Positron-Emission Tomography, Retrospective Studies, Thyroglobulin, Thyroid Neoplasms/diagnostic imaging",

author = "Lebbink, \{Chantal A.\} and \{de Vries\}, \{Lisa H.\} and \{Borel Rinkes\}, \{Inne H.M.\} and Braat, \{Arthur J.A.T.\} and \{van Leeuwaarde\}, \{Rachel S.\} and Lutske Lodewijk and \{van Treijen\}, \{Mark J.C.\} and Vriens, \{Menno R.\} and Valk, \{Gerlof D.\} and \{van Santen\}, \{Hanneke M.\} and \{de Keizer\}, Bart",

note = "Publisher Copyright: {\textcopyright} 2022 European Society of Endocrinology.",

year = "2022",

month = jul,

doi = "10.1530/EJE-22-0072",

language = "English",

volume = "187",

pages = "101--110",

journal = "European journal of endocrinology",

issn = "0804-4643",

publisher = "Oxford University Press",

number = "1",

}

TY - JOUR

T1 - FDG PET/CT in differentiated thyroid cancer patients with low thyroglobulin levels

AU - Lebbink, Chantal A.

AU - de Vries, Lisa H.

AU - Borel Rinkes, Inne H.M.

AU - Braat, Arthur J.A.T.

AU - van Leeuwaarde, Rachel S.

AU - Lodewijk, Lutske

AU - van Treijen, Mark J.C.

AU - Vriens, Menno R.

AU - Valk, Gerlof D.

AU - van Santen, Hanneke M.

AU - de Keizer, Bart

PY - 2022/7

Y1 - 2022/7

N2 - OBJECTIVE: To evaluate the usefulness of [18F]fluorodeoxyglucose (FDG) positron emissive tomography (PET)/CT in patients with low detectable thyroglobulin levels suspicious for persistent or recurrent differentiated thyroid cancer (DTC).METHODS: A retrospective case series study evaluating FDG PET/CT in patients with detectable thyroglobulin (Tg) levels (≥0.20 and <10.00 ng/mL) after initial treatment with total thyroidectomy and I-131 thyroid remnant ablation for pT1-3aN0-1bM0 DTC. Sensitivity, specificity, positive (PPV) and negative predictive value (NPV) of FDG PET/CT were calculated.RESULTS: Twenty-seven patients underwent FDG PET/CT. Median Tg level at FDG PET/CT was 2.00 ng/mL (range 0.30-9.00). FDG PET/CT was positive in 14 patients (51.9%): lesions suspicious for lymph node metastases were depicted in 12 patients, and lung metastases in 2. DTC was confirmed in 13/14 FDG PET/CT-positive patients. In 9/13 patients with a negative FDG PET/CT, DTC was confirmed ≤3 months after FDG PET/CT. The sensitivity, PPV, specificity and NPV were 59.1, 92.9, 80.0 and 30.8%, respectively.CONCLUSIONS: This case series shows that FDG PET/CT might be useful to detect persistent or recurrent DTC in patients with low detectable Tg. However, when FDG PET/CT is negative, this does not rule out DTC and further investigations are necessary.

AB - OBJECTIVE: To evaluate the usefulness of [18F]fluorodeoxyglucose (FDG) positron emissive tomography (PET)/CT in patients with low detectable thyroglobulin levels suspicious for persistent or recurrent differentiated thyroid cancer (DTC).METHODS: A retrospective case series study evaluating FDG PET/CT in patients with detectable thyroglobulin (Tg) levels (≥0.20 and <10.00 ng/mL) after initial treatment with total thyroidectomy and I-131 thyroid remnant ablation for pT1-3aN0-1bM0 DTC. Sensitivity, specificity, positive (PPV) and negative predictive value (NPV) of FDG PET/CT were calculated.RESULTS: Twenty-seven patients underwent FDG PET/CT. Median Tg level at FDG PET/CT was 2.00 ng/mL (range 0.30-9.00). FDG PET/CT was positive in 14 patients (51.9%): lesions suspicious for lymph node metastases were depicted in 12 patients, and lung metastases in 2. DTC was confirmed in 13/14 FDG PET/CT-positive patients. In 9/13 patients with a negative FDG PET/CT, DTC was confirmed ≤3 months after FDG PET/CT. The sensitivity, PPV, specificity and NPV were 59.1, 92.9, 80.0 and 30.8%, respectively.CONCLUSIONS: This case series shows that FDG PET/CT might be useful to detect persistent or recurrent DTC in patients with low detectable Tg. However, when FDG PET/CT is negative, this does not rule out DTC and further investigations are necessary.

KW - Adenocarcinoma

KW - Fluorodeoxyglucose F18

KW - Humans

KW - Iodine Radioisotopes

KW - Neoplasm Recurrence, Local/pathology

KW - Positron Emission Tomography Computed Tomography

KW - Positron-Emission Tomography

KW - Retrospective Studies

KW - Thyroglobulin

KW - Thyroid Neoplasms/diagnostic imaging

UR - https://www.scopus.com/pages/publications/85130863284

U2 - 10.1530/EJE-22-0072

DO - 10.1530/EJE-22-0072

M3 - Article

C2 - 35521710

AN - SCOPUS:85130863284

SN - 0804-4643

VL - 187

SP - 101

EP - 110

JO - European journal of endocrinology

JF - European journal of endocrinology

IS - 1

ER -

FDG PET/CT in differentiated thyroid cancer patients with low thyroglobulin levels

Abstract

Keywords

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