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KMID : 1148920090430060543
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Nuclear Medicine and Molecular Imaging
2009 Volume.43 No. 6 p.543 ~ p.556
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18F-FDG PET/CT for the Preoperative Diagnosis of Papillary Thyroid Microcarcinoma: The Value of Dual Time Point Imaging
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Seo Young-Duk
Kim Seong-Min
Kim Kun-Ho
Kim Je-Ryong
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Abstract
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Purpose: We studied the patterns of FDG uptake of primary papillary thyroid microcarcinoma (PTMCa) lesions and benign thyroid nodules in dual time point 18F-FDG PET/CT imaging.
Materials and Methods: Consecutive 134 patients (154 lesions) with PTMCa and 49 patients (61 nodules) with benign thyroid nodules equal to or less than 1.0 cm who underwent dual time point 18F-FDG PET/CT study before surgery were enrolled. We calculated the maximum standardized uptake value of PTMCa and benign nodules in both time points, and percent change of SUVmax (Δ%SUVmax) and lesion to background ratio of SUVmax (Δ%L:B ratio) between both time points. The mean time interval between scans was 23.4±4.4 minutes (thyroid to thyroid interval: 10.7±4.4 minutes).
Results: The mean of SUVmax of PTMCa was increased from 4.9±4.3 to 5.3±4.7 (p<0.001) and Δ%SUVmax was 12.3±23.6%. But, the mean of SUVmax of benign nodules was no definite change (2.1±1.0 to 2.1±1.3, p=0.686) and Δ%SUVmax was -0.3±20.5%. Of the 154 PTMCa, 100 nodules (64.9%) showed an increase in SUVmax over time, while 19 (31.1%) of the 61 benign thyroid nodules showed an increase (p<0.001). The dual time point 18F-FDG PET/CT found more PTMCa in visual assessment (62.3% vs. 76.6%, p=0.006), even in smaller than 0.5 cm (38.6% vs. 60.0%, p=0.011).
Conclusion: Dual time time 18F-FDG PET/CT imaging was more useful than single time point 18F-FDG PET/CT imaging for distinction between PTMCa and benign nodule, especially when nodule showed equivocal or negative findings in single time point 18F-FDG PET/CT imaging or was smaller than 0.5 cm.
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KEYWORD
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Papillary thyroid microcarcinoma, FDG PET/CT, dual time point imaging
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