RESUMEN
OBJECTIVE: Fluorodeoxyglucose positron emission tomography/computed tomography imaging in the follow-up of patients with differentiated thyroid carcinoma who have high serum thyroglobulin, negative iodine-131 whole body scan and suppressed thyrotropin. PATIENTS AND METHODS: A total of 90 patients (31 male and 59 female) with differentiated thyroid carcinoma who have high serum thyroglobulin and negative iodine-131 whole body scan were included in the study between July 2006 and March 2014. All patients had undergone surgery (total thyroidectomy ± lymph node dissection) followed by iodine-131 ablation. Of the patients, 82 had papillary thyroid carcinoma and 8 follicular thyroid carcinoma. Serum thyrotropin was suppressed (< 2 µ IU/ml) during the Fluor-18 fluorodeoxyglucose positron emission tomography/computed tomography imaging procedure. RESULTS: The overall sensitivity of fluor-18 fluorodeoxyglucose positron emission tomography/computed tomography imaging in the detection of metastasis of differentiated thyroid cancer was 84.8%, the specificity 79.1%, respectively. The sensitivity and specificity of fluor-18 fluorodeoxyglucose positron emission tomography/computed tomography imaging in classic type of papillary cancer was 83.3% and 54.5%, respectively. The corresponding figures for the tall cell variant was 85.7% and 87.5%, respectively. The difference between the two histological subtypes was statistically significant (p < 0.05). CONCLUSIONS: Our results suggest that fluor-18 fluorodeoxyglucose positron emission tomography/computed tomography imaging could be a valuable test for the routine follow-up of patients with differentiated thyroid carcinoma.
Asunto(s)
Tomografía de Emisión de Positrones , Tiroglobulina/sangre , Neoplasias de la Tiroides/sangre , Tirotropina/sangre , Tomografía Computarizada por Rayos X , Imagen de Cuerpo Entero , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Femenino , Fluorodesoxiglucosa F18 , Estudios de Seguimiento , Humanos , Radioisótopos de Yodo , Masculino , Persona de Mediana Edad , Tomografía de Emisión de Positrones/tendencias , Neoplasias de la Tiroides/diagnóstico , Factores de Tiempo , Tomografía Computarizada por Rayos X/tendencias , Imagen de Cuerpo Entero/tendencias , Adulto JovenRESUMEN
Introducción La localización más común de las metástasis a distancia en tumores diferenciados de tiroides es el pulmón. En este estudio se pretende determinar la proporción de metástasis pulmonares en el cáncer diferenciado de tiroides y su respuesta a la terapia con radioyodo. Material y métodos. Quinientos cuarenta y dos pacientes con cáncer diferenciado de tiroides fueron incluidos en este estudio. Se administraron altas dosis de 131I a los pacientes con metástasis pulmonares. La respuesta a la terapia se evaluó con estudios con 131I y niveles de tiroglobulina estimulada al menos 6 meses después de la terapia inicial. Resultados. Se detectaron metástasis pulmonares en 17 (3,1%) de los 542 pacientes. Tras la terapia con dosis altas de 131I se observó respuesta completa en 5 (29,4%), respuesta parcial en 3 (17,6%) y no se obtuvo respuesta en 9 (53%) de los pacientes. Conclusión. Aunque las metástasis pulmonares en los cánceres diferenciados de tiroides son raras, son más frecuentes en edades avanzadas y en varones. Altas dosis de 131I pueden ser beneficiosas, aunque habitualmente esta terapia debe repetirse(AU)
Introduction. The most common site of metastases in differentiated thyroid carcinomas is the lungs. In our study, we aimed to determine the ratios of lung metastases in patients with differentiated thyroid carcinoma and response to radioiodine therapy. Material and methods. A total of 542 patients with differentiated thyroid carcinoma who were admitted to our clinic were included in the study. High doses of 131I were administered to the patients with lung metastases. Response to therapy were evaluated with 131I scans and stimulated serum Tg levels were examined at least 6 months after therapy. Results. Lung metastases were detected in 17 (3.1%) of 542 patients with differentiated thyroid carcinoma. Of these patients to whom high doses of 131I therapy were administered, complete response to therapy was obtained in 5 (29.4%), partial response was obtained in 3 (17.6%) and no response could be obtained in 9 (53%) patients. Conclusion. Although lung metastases from differentiated thyroid carcinomas are rare, those are more common in advanced ages and in males. High doses of 131I therapy may be partially beneficial in these patients. Thus repetition of therapy is frequently required(AU)
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Neoplasias Pulmonares , Metástasis de la Neoplasia/diagnóstico , Metástasis de la Neoplasia , Yodo/uso terapéutico , 3-Yodobencilguanidina/uso terapéutico , Tiroglobulina/uso terapéutico , Neoplasias de la Tiroides/complicaciones , Neoplasias de la Tiroides , Pruebas de Función de la Tiroides/métodos , Glándula Tiroides/patología , Glándula TiroidesRESUMEN
OBJECTIVE: This study has aimed to evaluate the impact of (F18) Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography (FDG PET-CT) in the differential diagnosis of malignant and benign pleural lesions in patients with suspected malignant pleural mesothelioma (MPM). MATERIAL AND METHODS: Fifty patients (32 females, 18 males; age range 24-79 years) with pleural thickening, fluid, plaques or calcification on previous CT scan were examined with FDG PET-CT. PET-CT imaging was obtained 1 h after FDG injection. In 12 patients, delayed imaging from the thoracic region was performed 2 h after injection. FDG uptake was evaluated visually and semiquantitively using standardized uptake value (SUV). FDG PET-CT findings were compared with histopathologic diagnosis. RESULTS: Thirty-nine patients had increased FDG uptake in pleural lesions but PET-CT results were negative in 11 patients. When compared with histopathological results in FDG positive group, 34 patients had MPM, 5 had benign pathology; in FDG negative group 8 patients had benign pathology, 3 had MPM. Of patients with delayed imaging, 9 showed increased SUV but 3 had a decreased SUV on delayed images. Increased SUV group had 4 MPM, 5 benign pathology (3 chronic granulomatous inflammation, 2 benign asbestotic plaque). Decreased SUV group all had benign pathology (fibrosis, chronic inflammation, myofibrosis). DISCUSSION: FDG PET-CT is a useful imaging modality in differential diagnosis of malignant and benign pleural lesions. Delayed imaging seems to be useful if there is a decrease in SUV suggesting a benign pathology but does not seem to contribute to the differential diagnosis if the SUV is increased.
Asunto(s)
Radioisótopos de Flúor , Fluorodesoxiglucosa F18 , Enfermedades Pleurales/diagnóstico por imagen , Radiofármacos , Adulto , Anciano , Asbestosis/diagnóstico por imagen , Asbestosis/patología , Diagnóstico Diferencial , Femenino , Granuloma/diagnóstico por imagen , Granuloma/patología , Humanos , Masculino , Mesotelioma/diagnóstico por imagen , Mesotelioma/patología , Persona de Mediana Edad , Imagen Multimodal , Enfermedades Pleurales/patología , Neoplasias Pleurales/diagnóstico por imagen , Neoplasias Pleurales/patología , Tomografía de Emisión de Positrones , Estudios Retrospectivos , España , Tomografía Computarizada por Rayos X , Adulto JovenRESUMEN
INTRODUCTION: The most common site of metastases in differentiated thyroid carcinomas is the lungs. In our study, we aimed to determine the ratios of lung metastases in patients with differentiated thyroid carcinoma and response to radioiodine therapy. MATERIAL AND METHODS: A total of 542 patients with differentiated thyroid carcinoma who were admitted to our clinic were included in the study. High doses of (131)I were administered to the patients with lung metastases. Response to therapy were evaluated with (131)I scans and stimulated serum Tg levels were examined at least 6 months after therapy. RESULTS: Lung metastases were detected in 17 (3.1%) of 542 patients with differentiated thyroid carcinoma. Of these patients to whom high doses of (131)I therapy were administered, complete response to therapy was obtained in 5 (29.4%), partial response was obtained in 3 (17.6%) and no response could be obtained in 9 (53%) patients. CONCLUSION: Although lung metastases from differentiated thyroid carcinomas are rare, those are more common in advanced ages and in males. High doses of (131)I therapy may be partially beneficial in these patients. Thus repetition of therapy is frequently required.
Asunto(s)
Adenocarcinoma Folicular/secundario , Carcinoma Papilar/secundario , Radioisótopos de Yodo/uso terapéutico , Neoplasias Pulmonares/secundario , Radiofármacos/uso terapéutico , Neoplasias de la Tiroides/patología , Adenocarcinoma Folicular/sangre , Adenocarcinoma Folicular/diagnóstico por imagen , Adenocarcinoma Folicular/radioterapia , Adenocarcinoma Folicular/cirugía , Adulto , Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/secundario , Carcinoma Papilar/sangre , Carcinoma Papilar/diagnóstico por imagen , Carcinoma Papilar/radioterapia , Carcinoma Papilar/cirugía , Terapia Combinada , Femenino , Humanos , Neoplasias Pulmonares/sangre , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/radioterapia , Masculino , Prevalencia , Cintigrafía , Inducción de Remisión , Tiroglobulina/sangre , Neoplasias de la Tiroides/sangre , Neoplasias de la Tiroides/cirugía , Tiroidectomía , Resultado del Tratamiento , Imagen de Cuerpo Entero , Adulto JovenRESUMEN
Introducción. El propósito de este estudio fue el de estudiar el impacto de F-18 Fluoro Desoxi Tomografía-Tomografía por Emisión de tomografía computerizada (FDG y PET-TAC) sobre la diagnosis diferencial de lesiones benignas y malignas en pacientes con sospecha de mesotelioma pleural maligno. Pacientes y métodos. Cincuenta pacientes (32 mujeres, 18 hombres, rango de edad 24-79 años, edad media 57,6) con engrosamiento pleural, derrame pleural, placas o calcificaciones vistas en imágenes en estudios previos con TAC fueron sometidos a la PET-TAC con FDG. Tras la inyección intravenosa de la FDG, se realizaron imágenes PET-TAC al cabo de una hora. Se obtuvieron imágenes tardías de la región torácica a las 2 horas de la inyección. Se llevaron a cabo análisis visual y semi cuantitativos con el valor de captación estándar (SUV). Los resultados del FDG PET-TAC fueron comparados con el diagnóstico histopatológico. Resultados. 39 pacientes demostraron captación aumentada en lesiones pleurales. Los resultados en la PET-TAC fueron negativos en 11 pacientes. Al comparar los resultados histopatológicos en el grupo de FDG-positivo, 34 pacientes tenían mesotelioma pleural maligno (MPM), 5 pacientes tenían patologías benignas. En el grupo FDG-negativo, las patologías fueron benignas en 8 pacientes, 3 pacientes tuvieron MPM. En los pacientes con imágenes tardías, 9 demostraron SUV aumentado, pero 3 tuvieron SUV disminuido en las imágenes tardías. En el grupo con SUV aumentado, 4 tuvieron MPM, 5 patología benigna (3, inflamación granulomatosa, y 2 placas asbestosis benignos). En el grupo de SUV disminuido, todos tuvieron patología benigna (la fibrosis, inflamación crónica, miofibrosis). Discusión. La FDG PET-TAC es una modalidad de imágenes útil en el diagnóstico diferencial de lesiones pleurales benignas y malignas. Imágenes tardías parecen ser útiles si existe una disminución en SUV sugerente de una patología benigna. Sin embargo, no parece contribuir a un diagnóstico diferencial si el SUV se aumenta(AU)
Objective. This study has aimed to evaluate the impact of F18 Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography (FDG PET-CT) in the differential diagnosis of malignant and benign pleural lesions in patients with suspected malignant pleural mesothelioma (MPM). Material and methods. Fifty patients (32 females, 18 males; age range 24-79 years) with pleural thickening, fluid, plaques or calcification on previous CT scan were examined with FDG PET-CT. PET-CT imaging was obtained 1h after FDG injection. In 12 patients, delayed imaging from the thoracic region was performed 2h after injection. FDG uptake was evaluated visually and semiquantitively using standardized uptake value (SUV). FDG PET-CT findings were compared with histopathologic diagnosis. Results. Thirty-nine patients had increased FDG uptake in pleural lesions but PET-CT results were negative in 11 patients. When compared with histopathological results in FDG positive group, 34 patients had MPM, 5 had benign pathology; in FDG negative group 8 patients had benign pathology, 3 had MPM. Of patients with delayed imaging, 9 showed increased SUV but 3 had a decreased SUV on delayed images. Increased SUV group had 4 MPM, 5 benign pathology (3 chronic granulomatous inflammation, 2 benign asbestotic plaque). Decreased SUV group all had benign pathology (fibrosis, chronic inflammation, myofibrosis). Discussion. FDG PET-CT is a useful imaging modality in differential diagnosis of malignant and benign pleural lesions. Delayed imaging seems to be useful if there is a decrease in SUV suggesting a benign pathology but does not seem to contribute to the differential diagnosis if the SUV is increased(AU)