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Thyroglobulin levels and thyroglobulin doubling time independently predict a positive 18F-FDG PET/CT scan in patients with biochemical recurrence of differentiated thyroid carcinoma

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To assess the relationship between serum thyroglobulin (Tg) levels, Tg doubling time (Tg-DT) and the diagnostic performance of 18F-FDG PET/CT in detecting recurrences of 131I-negative differentiated thyroid carcinoma (DTC).

Methods

Included in the present study were 102 patients with DTC. All patients were treated by thyroid ablation (e.g. thyroidectomy and 131I), and underwent 18F-FDG PET/CT due to detectable Tg levels and negative conventional imaging. Consecutive serum Tg measurements performed before the 18F-FDG PET/CT examination were used for Tg-DT calculation. The 18F-FDG PET/CT results were assessed as true or false after histological and/or clinical follow-up.

Results

Serum Tg levels were higher in patients with a positive 18F-FDG PET/CT scan (median 6.7 ng/mL, range 0.7–73.6 ng/mL) than in patients with a negative scan (median 1.8 ng/mL, range 0.5–4.9 ng/mL; P < 0.001). In 43 (88 %) of 49 patients with a true-positive 18F-FDG PET/CT scan, the Tg levels were >5.5 ng/mL, and in 31 (74 %) of 42 patients with a true-negative 18F-FDG PET/CT scan, the Tg levels were ≤5.5 ng/mL. A Tg-DT of <1 year was found in 46 of 49 patients (94 %) with a true-positive 18F-FDG PET/CT scan, and 40 of 42 patients (95 %) with a true-negative scan had a stable or increased Tg-DT. Moreover, combining Tg levels and Tg-DT as selection criteria correctly distinguished between patients with a positive and a negative scan (P<0.0001).

Conclusion

The accuracy of 18F-FDG PET/CT significantly improves when the serum Tg level is above 5.5 ng/mL during levothyroxine treatment or when the Tg-DT is less than 1 year, independent of the absolute value.

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Authors and Affiliations

  1. Department of Nuclear Medicine and Thyroid Centre, Oncology Institute of Southern Switzerland, Via Ospedale 12, 6500, Bellinzona, Switzerland

    Luca Giovanella, Giorgio Treglia & Luca Ceriani

  2. Department of Clinical Chemistry and Laboratory Medicine, Ente Ospedaliero Cantonale, Bellinzona, Switzerland

    Luca Giovanella

  3. Section of Endocrinology and Diabetology, Ospedale Israelitico, Roma, Italy

    Pierpaolo Trimboli

  4. Department of Nuclear Medicine, Aachen University Hospital, Aachen, Germany

    Frederik A. Verburg

  5. Department of Nuclear Medicine, Galliera Hospital, Genova, Italy

    Arnoldo Piccardo

  6. Department of Endocrinology, Galliera Hospital, Genova, Italy

    Luca Foppiani

Authors
  1. Luca Giovanella
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  2. Pierpaolo Trimboli
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  3. Frederik A. Verburg
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  4. Giorgio Treglia
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  5. Arnoldo Piccardo
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  6. Luca Foppiani
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  7. Luca Ceriani
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Correspondence to Luca Giovanella.

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Giovanella, L., Trimboli, P., Verburg, F.A. et al. Thyroglobulin levels and thyroglobulin doubling time independently predict a positive 18F-FDG PET/CT scan in patients with biochemical recurrence of differentiated thyroid carcinoma. Eur J Nucl Med Mol Imaging 40, 874–880 (2013). https://doi.org/10.1007/s00259-013-2370-6

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  • DOI: https://doi.org/10.1007/s00259-013-2370-6

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