Introduction: The aim of the study was to assess the role of I-124 PET/CT in the prediction of uptake of a therapeutic dosage I-131 during follow-up of patients with differentiated thyroid cancer (DTC). Methods: The r...Introduction: The aim of the study was to assess the role of I-124 PET/CT in the prediction of uptake of a therapeutic dosage I-131 during follow-up of patients with differentiated thyroid cancer (DTC). Methods: The results of 34 I-124 PET/CT scans performed in our hospital between 2007 and 2012 were retrospectively evaluated. All scans were made in patients under follow up, replacing the diagnostic I-131 or I-123 scintigraphy. In all cases thyroglobulin (Tg) was stimulated (by recombinant thyroid stimulating hormone (rhTSH) or thyroid hormone withdrawal). A dosage of 40 MBq I-124 was used, with scans at 24 hours and 96 hours after administration. Results were compared to subsequent I-131 post-treatment scans (6 cases) and a combination of follow up, stimulated Tg and other imaging tools results available to assess presence of recurrence. Results: Recurrence of DTC was found in 14/34 cases. I-124 PET/CT correctly detected recurrence in 2 cases, with false negative results in 12 cases. In 1 case a false positive I-124 PET/CT result was recorded. 19 true negative results were found. For I-124 PET/CT this meant a sensitivity of 14% and a specificity of 95%. Positive predictive value was 67%, negative predictive value 61%. Post-treatment I-131 uptake (6 cases) was correctly predicted in 1 case, with false negative results in 4 cases and 1 true negative result. Conclusions: In this study I-124 PET/CT did not reliably detect recurrent differentiated thyroid carcinoma. More importantly it failed to predict I-131 uptake on post-treatment scintigraphy in a significant number of cases, which would lead to under-treatment.展开更多
Objectives: In grade III-IV breast cancer, dissemination of disease needs to be assessed. Until now this was done by conventional imaging (liver ultrasonography, chest X-ray and bone scintigraphy), but evidence favori...Objectives: In grade III-IV breast cancer, dissemination of disease needs to be assessed. Until now this was done by conventional imaging (liver ultrasonography, chest X-ray and bone scintigraphy), but evidence favoring the use of FDG-PET/CT is accumulating. Methods: Patients with high-risk breast cancer, who had received conventional imaging and FDG-PET/CT, were included. Patients were staged and assigned a treatment after 1) conventional imaging and 2) FDG-PET/CT, both by a multidisciplinary oncology team. Equivocal FDG-PET/CT findings were histologically confirmed. Results: 16 patients were included (mean age 59 years). TNM-stage changed in 5 patients (31%) after FDG-PET/CT. In 3 patients (19%) unknown distant metastases were detected by FDG-PET/CT. An adjustment of treatment took place in 4 patients (25%). Conclusions: Our case series emphasizes the role of FDG-PET/CT in the staging of high-risk breast carcinoma, especially in the assessment of distant metastases. We suggest replacing conventional imaging with FDG-PET/CT.展开更多
文摘Introduction: The aim of the study was to assess the role of I-124 PET/CT in the prediction of uptake of a therapeutic dosage I-131 during follow-up of patients with differentiated thyroid cancer (DTC). Methods: The results of 34 I-124 PET/CT scans performed in our hospital between 2007 and 2012 were retrospectively evaluated. All scans were made in patients under follow up, replacing the diagnostic I-131 or I-123 scintigraphy. In all cases thyroglobulin (Tg) was stimulated (by recombinant thyroid stimulating hormone (rhTSH) or thyroid hormone withdrawal). A dosage of 40 MBq I-124 was used, with scans at 24 hours and 96 hours after administration. Results were compared to subsequent I-131 post-treatment scans (6 cases) and a combination of follow up, stimulated Tg and other imaging tools results available to assess presence of recurrence. Results: Recurrence of DTC was found in 14/34 cases. I-124 PET/CT correctly detected recurrence in 2 cases, with false negative results in 12 cases. In 1 case a false positive I-124 PET/CT result was recorded. 19 true negative results were found. For I-124 PET/CT this meant a sensitivity of 14% and a specificity of 95%. Positive predictive value was 67%, negative predictive value 61%. Post-treatment I-131 uptake (6 cases) was correctly predicted in 1 case, with false negative results in 4 cases and 1 true negative result. Conclusions: In this study I-124 PET/CT did not reliably detect recurrent differentiated thyroid carcinoma. More importantly it failed to predict I-131 uptake on post-treatment scintigraphy in a significant number of cases, which would lead to under-treatment.
文摘Objectives: In grade III-IV breast cancer, dissemination of disease needs to be assessed. Until now this was done by conventional imaging (liver ultrasonography, chest X-ray and bone scintigraphy), but evidence favoring the use of FDG-PET/CT is accumulating. Methods: Patients with high-risk breast cancer, who had received conventional imaging and FDG-PET/CT, were included. Patients were staged and assigned a treatment after 1) conventional imaging and 2) FDG-PET/CT, both by a multidisciplinary oncology team. Equivocal FDG-PET/CT findings were histologically confirmed. Results: 16 patients were included (mean age 59 years). TNM-stage changed in 5 patients (31%) after FDG-PET/CT. In 3 patients (19%) unknown distant metastases were detected by FDG-PET/CT. An adjustment of treatment took place in 4 patients (25%). Conclusions: Our case series emphasizes the role of FDG-PET/CT in the staging of high-risk breast carcinoma, especially in the assessment of distant metastases. We suggest replacing conventional imaging with FDG-PET/CT.
