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Background <p>A significant sub-group of patients with differentiated thyroid carcinoma of follicular origin (DTC) shows recurrence and disease progression after radioactive iodine treatment (RAI), hence precise identification of the tumor localisation is essential. The aim was to evaluate the performance of Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography coupled with computed tomography (<sup>18</sup>F-FDG PET/CT) in the follow-up of DTC and to assess the therapeutic impact of this examination.</p> Methods <p>This is a cross-sectional, monocentric study conducted at the nuclear medicine department between November 2019 and November 2023. This study included 30 patients monitored for DTC and explored by <sup>18</sup>F-FDG PET/CT in the setting of persistent residual disease or recurrence.</p> Results <p>During follow-up, refractory DTC was diagnosed in 23 patients (77%) with an incomplete structural response and thyroglobulin (Tg) level exceeded 100&#xa0;ng/ml in 50% of cases. For the seven remaining patients classified as having an incomplete biochemical response, <sup>18</sup>F-FDG PET scans identified cervical lymph node metastases in two patients. Overall PET performances were 89.3%, 94%, 85.7%, 96% and 93% for sensitivity, specificity, positive predictive value, negative predictive value, and accuracy respectively. The results of <sup>18</sup>F-FDG PET/CT led to a change in treatment plan in 30% of cases.</p> Conclusions <p><sup>18</sup>F-FDG PET/CT has demonstrated its usefulness in detecting refractory lesions after RAI with a significant impact on therapeutic management. It would be interesting to increase the follow-up time and the sample size in order to better study its prognostic value.</p>

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Monitoring persistent and recurrent differentiated thyroid carcinoma: Diagnostic performance of 18F-FDG PET/CT

  • 期刊论文

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  • 发表日期：

    2025年9月25日

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  • Teheni Dardouri,
  • Hajer Boudriga,
  • Abir Ezzine,
  • Sihem Mensi,
  • Jihene Houas,
  • Manel Nouira,
  • Maha Ben Fredj,
  • Raja Sfar,
  • Kaouthar Chatti

摘要

Background

A significant sub-group of patients with differentiated thyroid carcinoma of follicular origin (DTC) shows recurrence and disease progression after radioactive iodine treatment (RAI), hence precise identification of the tumor localisation is essential. The aim was to evaluate the performance of Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography coupled with computed tomography (18F-FDG PET/CT) in the follow-up of DTC and to assess the therapeutic impact of this examination.

Methods

This is a cross-sectional, monocentric study conducted at the nuclear medicine department between November 2019 and November 2023. This study included 30 patients monitored for DTC and explored by 18F-FDG PET/CT in the setting of persistent residual disease or recurrence.

Results

During follow-up, refractory DTC was diagnosed in 23 patients (77%) with an incomplete structural response and thyroglobulin (Tg) level exceeded 100 ng/ml in 50% of cases. For the seven remaining patients classified as having an incomplete biochemical response, 18F-FDG PET scans identified cervical lymph node metastases in two patients. Overall PET performances were 89.3%, 94%, 85.7%, 96% and 93% for sensitivity, specificity, positive predictive value, negative predictive value, and accuracy respectively. The results of 18F-FDG PET/CT led to a change in treatment plan in 30% of cases.

Conclusions

18F-FDG PET/CT has demonstrated its usefulness in detecting refractory lesions after RAI with a significant impact on therapeutic management. It would be interesting to increase the follow-up time and the sample size in order to better study its prognostic value.