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KMID : 1202020080010020107
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Journal of Korean Thyroid Association
2008 Volume.1 No. 2 p.107 ~ p.111
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Utility of FDG PET/CT Scans on Nodal Staging in Patients with Papillary Thyroid Cancer
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Joo Young-Hoon
Yun Chang-Hyun
Cho Jung-Hae
Sun Dong-Il
Yoo Ie-Ryung
Jung So-Lyung
Kim Min-Sik
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Abstract
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Background and Objectives: Accurate evaluation of cervical lymph node status of apillary thyroid cancer (PTC) is important to treatment planning and prognosis prediction. In this study, we evaluated the use of FDG PET/CT, ultrasound, CT or MRI (CT/MRI) for the identification of cervical nodal metastasis of PTC with histologic correlation.
Materials and Methods: We reviewed 28 medical records, from 2004 August to 2007 September, of patients who underwent of FDG PET/CT, ultrasound, CT/MRI for PTC before surgery. We interpreted FDG PET/CT, ultrasound, CT/MRI to assess the regional lymph node status. We recorded lymph node metastasis according to the neck level system of imaging-based nodal classification.
Results: All patients received neck dissection and 11 patients did bilateral neck dissections. Thirteen patients received total thyroidectomy and 15 patients did completion thyroidectomy. Histopathology revealed metastases in 33 of 39 (28 plus 11) dissected neck sides and in 80 of 164 dissected cervical levels. FDG PET/CT was more sensitive than CT/MRI for identification of cervical metastases on level-by-level bases (51/80 vs. 41/80; p=0.002). But the sensitivity of FDG PET/CT and ultrasound did not differ significantly (p=1.000). In combined modalities of FDG PET/CT and ultrasound, the sensitivity was 81.3% and higher than that of FDG PET/CT, ultrasound (p＜0.001, p＜0.001, respectively). The median SUVmax of pathologically positive node levels was 5.64±3.11 (range 1.4∼22.5) and that of pathologically negative node levels was 3.31±3.23 (range 1.2∼14.2)(p=0.039).
Conclusion: The combination of FDG PET/CT and ultrasound improves cervical staging of PTC that are often not found if only one imaging modalities are applied.
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KEYWORD
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Thyroid neoplasms, Carcinoma, Papillary, Lymphatic metastasis, Positron-emission tomography
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