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Peștean C, Pavel A, Piciu D. The Role of SPECT/CT and PET/CT Hybrid Imaging in the Management of Ectopic Thyroid Carcinoma-A Systematic Review. Diagnostics (Basel) 2024; 14:1369. [PMID: 39001259 PMCID: PMC11241737 DOI: 10.3390/diagnostics14131369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 05/28/2024] [Accepted: 06/26/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Thyroid ectopy represents a rare disease with an incidence of 0.3-1/100,000. It occurs due to the defective embryological process of the thyroid gland development. The thyroid ectopic tissue may suffer malignant transformation. This review aims to shed light on the roles that I-131 SPECT/CT (radioiodine 131 single-photon emission tomography fused with computed tomography) and F-18 PET/CT (fluorodeoxyglucose F18 positron emission tomography fused with computer tomography) may play in managing patients with ectopic thyroid carcinoma. MATERIALS AND METHODS A total number of 47 articles were identified on the PubMed and Google Scholar databases, and 3 other articles were selected from articles identified in the references cited in the retrieved articles. After refining the selection, the inclusion and exclusion criteria were applied, resulting in 10 articles that were included in the review. RESULTS The cases of ectopy included in this review were localised as follows: four cases in the thyroglossal duct, two cases in the mediastinum, one case in the oesophagus, one case in the thorax, one case with a pre-tracheal location, and one case with a latero-cervical location. In all the cases, F-18 FDG PET/CT was used as a diagnostic tool. In one case, F-18 FDG PET/CT was combined with I-131 SPECT/CT and MRI (magnetic resonance imaging). In one case, it was combined with 68 Ga-FAPI PET/CT (Ga-68 radiolabelled FAP inhibitor positron emission tomography fused with computer tomography). The maximum SUVs (standardised uptake values) ranged from 5.5 to 25 g/mL. CONCLUSIONS F-18 PET/CT and I-131 SPECT/CT hybrid nuclear imaging is of great value in assessing ectopic thyroid carcinoma. F-18 FDG PET/CT plays an important role in the primary tumour evaluation and distant disease detection. Ga-68 FAPIs are a promising alternative. I-131 SPECT/CT adds important information related to the anatomical characterization of primary and distant iodine-avid lesions.
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Affiliation(s)
- Claudiu Peștean
- Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.P.); (D.P.)
- “Ion Chiricuță” Oncology Institute, 400015 Cluj-Napoca, Romania
- Affidea CT Clinic, 400015 Cluj-Napoca, Romania
| | - Alexandru Pavel
- Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.P.); (D.P.)
- Affidea CT Clinic, 400015 Cluj-Napoca, Romania
- Emergency Clinical County Hospital Cluj-Napoca, 400347 Cluj-Napoca, Romania
| | - Doina Piciu
- Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (C.P.); (D.P.)
- Affidea CT Clinic, 400015 Cluj-Napoca, Romania
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Ju SH, Lee SE, Yi S, Choi NR, Kim KH, Kim SM, Koh JY, Kim SK, Kim SY, Heo JY, Park JO, Park S, Koo BS, Kang YE. Transcriptomic characteristics according to tumor size and SUV max in papillary thyroid cancer patients. Sci Rep 2024; 14:11005. [PMID: 38745021 PMCID: PMC11094162 DOI: 10.1038/s41598-024-61839-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 05/10/2024] [Indexed: 05/16/2024] Open
Abstract
The SUVmax is a measure of FDG uptake and is related with tumor aggressiveness in thyroid cancer, however, its association with molecular pathways is unclear. Here, we investigated the relationship between SUVmax and gene expression profiles in 80 papillary thyroid cancer (PTC) patients. We conducted an analysis of DEGs and enriched pathways in relation to SUVmax and tumor size. SUVmax showed a positive correlation with tumor size and correlated with glucose metabolic process. The genes that indicate thyroid differentiation, such as SLC5A5 and TPO, were negatively correlated with SUVmax. Unsupervised analysis revealed that SUVmax positively correlated with DNA replication(r = 0.29, p = 0.009), pyrimidine metabolism(r = 0.50, p < 0.0001) and purine metabolism (r = 0.42, p = 0.0001). Based on subgroups analysis, we identified that PSG5, TFF3, SOX2, SL5A5, SLC5A7, HOXD10, FER1L6, and IFNA1 genes were found to be significantly associated with tumor aggressiveness. Both high SUVmax PTMC and macro-PTC are enriched in pathways of DNA replication and cell cycle, however, gene sets for purine metabolic pathways are enriched only in high SUVmax macro-PTC but not in high SUVmax PTMC. Our findings demonstrate the molecular characteristics of high SUVmax tumor and metabolism involved in tumor growth in differentiated thyroid cancer.
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Affiliation(s)
- Sang-Hyeon Ju
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University Hospital and College of Medicine, Daejeon, Republic of Korea
| | - Seong Eun Lee
- Research Center for Endocrine and Metabolic Disease, Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon, 35015, Republic of Korea
| | - Shinae Yi
- Research Center for Endocrine and Metabolic Disease, Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon, 35015, Republic of Korea
| | - Na Rae Choi
- Research Center for Endocrine and Metabolic Disease, Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon, 35015, Republic of Korea
| | - Kun Ho Kim
- Department of Nuclear Medicine, Chungnam National University Hospital and College of Medicine, Daejeon, Republic of Korea
| | - Seong Min Kim
- Department of Nuclear Medicine, Chungnam National University Hospital and College of Medicine, Daejeon, Republic of Korea
| | - June-Young Koh
- GENOME INSIGHT THECNOLOGY Inc, Daejeon, 35015, Republic of Korea
| | - Seon-Kyu Kim
- Personalized Genomic Medicine Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
| | - Seon-Young Kim
- Korea Bioinformation Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
| | - Jun Young Heo
- Department of Biochemistry, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Junyoung O Park
- Department of Chemical and Biomolecular Engineering, University of California, Los Angeles, Los Angeles, CA, USA
| | - Seongyeol Park
- GENOME INSIGHT THECNOLOGY Inc, Daejeon, 35015, Republic of Korea.
| | - Bon Seok Koo
- Department of Otolaryngology-Head and Neck Surgery, Chungnam National University Hospital and College of Medicine, Daejeon, 35015, Republic of Korea.
| | - Yea Eun Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chungnam National University Hospital and College of Medicine, Daejeon, Republic of Korea.
- Research Center for Endocrine and Metabolic Disease, Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon, 35015, Republic of Korea.
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3
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Bischoff LA, Ganly I, Fugazzola L, Buczek E, Faquin WC, Haugen BR, McIver B, McMullen CP, Newbold K, Rocke DJ, Russell MD, Ryder M, Sadow PM, Sherman E, Shindo M, Shonka DC, Singer MC, Stack BC, Wirth LJ, Wong RJ, Randolph GW. Molecular Alterations and Comprehensive Clinical Management of Oncocytic Thyroid Carcinoma: A Review and Multidisciplinary 2023 Update. JAMA Otolaryngol Head Neck Surg 2024; 150:265-272. [PMID: 38206595 DOI: 10.1001/jamaoto.2023.4323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
Importance Oncocytic (Hürthle cell) thyroid carcinoma is a follicular cell-derived neoplasm that accounts for approximately 5% of all thyroid cancers. Until recently, it was categorized as a follicular thyroid carcinoma, and its management was standardized with that of other differentiated thyroid carcinomas. In 2022, given an improved understanding of the unique molecular profile and clinical behavior of oncocytic thyroid carcinoma, the World Health Organization reclassified oncocytic thyroid carcinoma as distinct from follicular thyroid carcinoma. The International Thyroid Oncology Group and the American Head and Neck Society then collaborated to review the existing evidence on oncocytic thyroid carcinoma, from diagnosis through clinical management and follow-up surveillance. Observations Given that oncocytic thyroid carcinoma was previously classified as a subtype of follicular thyroid carcinoma, it was clinically studied in that context. However, due to its low prevalence and previous classification schema, there are few studies that have specifically evaluated oncocytic thyroid carcinoma. Recent data indicate that oncocytic thyroid carcinoma is a distinct class of malignant thyroid tumor with a group of distinct genetic alterations and clinicopathologic features. Oncocytic thyroid carcinoma displays higher rates of somatic gene variants and genomic chromosomal loss of heterozygosity than do other thyroid cancers, and it harbors unique mitochondrial DNA variations. Clinically, oncocytic thyroid carcinoma is more likely to have locoregional (lymph node) metastases than is follicular thyroid carcinoma-with which it was formerly classified-and it develops distant metastases more frequently than papillary thyroid carcinoma. In addition, oncocytic thyroid carcinoma rarely absorbs radioiodine. Conclusions and Relevance The findings of this review suggest that the distinct clinical presentation of oncocytic thyroid carcinoma, including its metastatic behavior and its reduced avidity to radioiodine therapy, warrants a tailored disease management approach. The reclassification of oncocytic thyroid carcinoma by the World Health Organization is an important milestone toward developing a specific and comprehensive clinical management for oncocytic thyroid carcinoma that considers its distinct characteristics.
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Affiliation(s)
- Lindsay A Bischoff
- Department of Medicine, Division of Endocrinology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ian Ganly
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Laura Fugazzola
- Endocrine Oncology Unit, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Erin Buczek
- Department of Otolaryngology Head and Neck Surgery, The University of Kansas, Kansas City
| | - William C Faquin
- Departments of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Bryan R Haugen
- Department of Medicine, University of Colorado Cancer Center, University of Colorado School of Medicine, Aurora
| | - Bryan McIver
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Caitlin P McMullen
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Kate Newbold
- Thyroid Unit, Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Daniel J Rocke
- Department of Otolaryngology Head and Neck Surgery, Weill Medical College, Cornell University, New York, New York
| | - Marika D Russell
- Department of Otolaryngology-Head and Neck Surgery, Division of Thyroid and Parathyroid Endocrine Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston
| | - Mabel Ryder
- Division of Endocrinology and Medical Oncology, Mayo Clinic, Rochester, Minnesota
| | - Peter M Sadow
- Departments of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Eric Sherman
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Maisie Shindo
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland
| | - David C Shonka
- Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville
| | - Michael C Singer
- Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan
| | - Brendan C Stack
- Department of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield
| | - Lori J Wirth
- Departments of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston
| | - Richard J Wong
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Gregory W Randolph
- Department of Otolaryngology-Head and Neck Surgery, Division of Thyroid and Parathyroid Endocrine Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston
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Wang L. Mammography with deep learning for breast cancer detection. Front Oncol 2024; 14:1281922. [PMID: 38410114 PMCID: PMC10894909 DOI: 10.3389/fonc.2024.1281922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/19/2024] [Indexed: 02/28/2024] Open
Abstract
X-ray mammography is currently considered the golden standard method for breast cancer screening, however, it has limitations in terms of sensitivity and specificity. With the rapid advancements in deep learning techniques, it is possible to customize mammography for each patient, providing more accurate information for risk assessment, prognosis, and treatment planning. This paper aims to study the recent achievements of deep learning-based mammography for breast cancer detection and classification. This review paper highlights the potential of deep learning-assisted X-ray mammography in improving the accuracy of breast cancer screening. While the potential benefits are clear, it is essential to address the challenges associated with implementing this technology in clinical settings. Future research should focus on refining deep learning algorithms, ensuring data privacy, improving model interpretability, and establishing generalizability to successfully integrate deep learning-assisted mammography into routine breast cancer screening programs. It is hoped that the research findings will assist investigators, engineers, and clinicians in developing more effective breast imaging tools that provide accurate diagnosis, sensitivity, and specificity for breast cancer.
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Affiliation(s)
- Lulu Wang
- Biomedical Device Innovation Center, Shenzhen Technology University, Shenzhen, China
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Li P, Zhang Y, Xu T, Zhu J, Wei T, Zhao W. Sensitivities evaluation of five radiopharmaceuticals in four common medullary thyroid carcinoma metastatic sites on PET/CT: a network meta-analysis and systematic review. Nucl Med Commun 2023; 44:1114-1125. [PMID: 37769014 PMCID: PMC10631508 DOI: 10.1097/mnm.0000000000001773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/06/2023] [Indexed: 09/30/2023]
Abstract
OBJECTIVES Detecting medullary thyroid carcinoma (MTC) metastatic lesions accurately is still a challenge for clinicians. PET/computed tomography (PET/CT) seems to be the most effective method in recent years. However, the sensitivity of each radiopharmaceutical varies greatly in different metastatic sites. We aim to investigate and compare five novel and common PET or PET/CT radiopharmaceutical sensitivities at the four most frequent metastatic sites by network meta-analysis. METHODS We searched for studies evaluating PET/CT radiopharmaceutical sensitivities at different metastatic sites in PubMed, Web of Science, Embase, and Cochrane Library. The risk bias was analyzed, and publication bias was accessed by funnel plot asymmetry tests. We performed both global inconsistency and local inconsistency tests by evaluating the agreement between direct and indirect comparisons. Then, we made pairwise meta-analyses and network meta-analyses for each metastatic site. Finally, we performed the surface under the cumulative ranking curves (SUCRA) and calculated the SUCRA values to rank the probability of each radiopharmaceutical being the most sensitive method. RESULTS In our results, 243 patients from 9 clinical studies which accessed sensitivities of different radiopharmaceuticals in MTC metastatic sites were included. For lymph nodes and liver, TF2/ 68 Ga-SSM288 showed the highest SUCRA values (0.974 in lymph nodes, 0.979 in liver). The SUCRA values for 18 F-DOPA and 68 Ga-SSA for bone metastatic lesions were nearly identical (0.301 and 0.319, respectively) and were higher than the other three radiopharmaceuticals. For lung lesions, 11 C-methionine had the highest SUCRA value (0.412). CONCLUSION TF2/ 68 Ga-SSM288 had the best sensitivity in lymph nodes and liver lesions. 11 C-methionine was most sensitive in lung lesions. While 18 F-DOPA and 68 Ga-SSA had familiar sensitivities to be the best two radiopharmaceuticals.
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Affiliation(s)
- Pengyu Li
- Department of Thyroid Surgery, West China Hospital, Sichuan University and
| | - Yujie Zhang
- Laboratory of Thyroid and Parathyroid Disease, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Tianfeng Xu
- Department of Thyroid Surgery, West China Hospital, Sichuan University and
| | - Jingqiang Zhu
- Department of Thyroid Surgery, West China Hospital, Sichuan University and
| | - Tao Wei
- Department of Thyroid Surgery, West China Hospital, Sichuan University and
- Laboratory of Thyroid and Parathyroid Disease, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Wanjun Zhao
- Department of Thyroid Surgery, West China Hospital, Sichuan University and
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6
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Chen Y, Li D, Zhang X, Liu P, Meng F, Jin J, Shen Y. A devised thyroid segmentation with multi-stage modification based on Super-pixel U-Net under insufficient data. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:1728-1741. [PMID: 37137743 DOI: 10.1016/j.ultrasmedbio.2023.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 01/24/2023] [Accepted: 03/27/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVES The application of deep learning to medical image segmentation has received considerable attention. Nevertheless, when segmenting thyroid ultrasound images, it is difficult to achieve good segmentation results using deep learning methods because of the large number of nonthyroidal regions and insufficient training data. METHODS In this study, a Super-pixel U-Net, designed by adding a supplementary path to U-Net, was devised to boost the segmentation results of thyroids. The improved network can introduce more information into the network, boosting auxiliary segmentation results. A multi-stage modification is introduced in this method, which includes boundary segmentation, boundary repair, and auxiliary segmentation. To reduce the negative effects of non-thyroid regions in the segmentation, U-Net was utilized to obtain rough boundary outputs. Subsequently, another U-Net is trained to improve and repair the coverage of the boundary outputs. Super-pixel U-Net was applied in the third stage to assist in the segmentation of the thyroid more precisely. Finally, multidimensional indicators were used to compare the segmentation results of the proposed method with those of other comparison experiments. DISCUSSION The proposed method achieved an F1 Score of 0.9161 and an IoU of 0.9279. Furthermore, the proposed method also exhibits better performance in terms of shape similarity, with an average convexity of 0.9395. an average ratio of 0.9109, an average compactness of 0.8976, an average eccentricity of 0.9448, and an average rectangularity of 0.9289. The average area estimation indicator was 0.8857. CONCLUSION The proposed method exhibited superior performance, proving the improvements of the multi-stage modification and Super-pixel U-Net.
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Affiliation(s)
- Yifei Chen
- Department of Control Science and Engineering, Harbin Institute of Technology, Harbin, 150001 China
| | - Dandan Li
- Department of Control Science and Engineering, Harbin Institute of Technology, Harbin, 150001 China.
| | - Xin Zhang
- Department of Control Science and Engineering, Harbin Institute of Technology, Harbin, 150001 China
| | - Peng Liu
- Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, 150081 China; Endemic Disease Control Center, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081 China
| | - Fangang Meng
- Heilongjiang Provincial Key Laboratory of Trace Elements and Human Health, Harbin Medical University, Harbin, 150081 China; Endemic Disease Control Center, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081 China
| | - Jing Jin
- Department of Control Science and Engineering, Harbin Institute of Technology, Harbin, 150001 China
| | - Yi Shen
- Department of Control Science and Engineering, Harbin Institute of Technology, Harbin, 150001 China
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Wadsley J, Balasubramanian SP, Madani G, Munday J, Roques T, Rowe CW, Touska P, Boelaert K. Consensus statement on the management of incidentally discovered FDG avid thyroid nodules in patients being investigated for other cancers. Clin Endocrinol (Oxf) 2023. [PMID: 36878888 DOI: 10.1111/cen.14905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023]
Abstract
With the widespread use of 18F-fluorodeoxyglucose positron emission tomography (FDG PET/CT) in the investigation and staging of cancers, incidental discovery of FDG-avid thyroid nodules is becoming increasingly common, with a reported incidence in the range 1%-4% of FDG PET/CT scans. The risk of malignancy in an incidentally discovered FDG avid thyroid nodule is not clear due to selection bias in reported retrospective series but is likely to be less than 15%. Even in cases where the nodule is found to be malignant, the majority will be differentiated thyroid cancers with an excellent prognosis even without treatment. If, due to index cancer diagnosis, age and co-morbidities, it is unlikely that the patient will survive 5 years, further investigation of an incidental FDG avid thyroid nodule is unlikely to be warranted. We provide a consensus statement on the circumstances in which further investigation of FDG avid thyroid nodules with ultrasound and fine needle aspiration might be appropriate.
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Affiliation(s)
| | | | - Gitta Madani
- Imperial College Healthcare NHS Trust, London, UK
| | | | - Tom Roques
- Norfolk and Norwich Hospital, Norwich, UK
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Schlumberger M, Garcia C, Hadoux J, Klain M, Lamartina L. Functional imaging in thyroid cancer patients with metastases and therapeutic implications. Presse Med 2022; 51:104113. [PMID: 35131318 DOI: 10.1016/j.lpm.2022.104113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/26/2021] [Accepted: 01/28/2022] [Indexed: 12/16/2022] Open
Abstract
Functional imaging plays a central role in the management of thyroid cancer patients. In patients with a differentiated thyroid cancer (DTC), radioactive iodine (RAI) is used mostly with a therapeutic intent, either post-operatively or as the first line systemic treatment in patients with known structural disease. A whole body scan is performed a few days after the RAI administration, and this procedure is very sensitive to detect all tumor foci with RAI uptake. PET/CT with 18F-FDG complements the use of RAI at the initial evaluation of patients with high-risk DTC, during follow-up in those with rising serum thyroglobulin levels over time, for the work-up of patients with documented structural disease and for assessing the efficacy of focal or systemic treatment modalities. 18F-FDG uptake is a prognostic indicator in all these clinical conditions. A dosimetric approach with 124I PET/CT showed encouraging results. Several functional imaging modalities are currently available for medullary thyroid carcinoma (MTC) patients. 18F-FDG-PET/CT may be sensitive in MTC patients with high FDG uptake that signals aggressive disease. 18F-DOPA is the most sensitive imaging technique to visualize small tumor foci, and is also highly specific in patients with a known MTC, but should be complemented by a CT scan of the chest and by a MRI of the liver to detect small metastases.
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Affiliation(s)
- Martin Schlumberger
- Gustave Roussy, Service de Médecine Nucléaire et de Cancérologie Endocrinienne, 114 rue Edouard Vaillant, Villejuif 94800, France.
| | - Camilo Garcia
- Gustave Roussy, Service de Médecine Nucléaire et de Cancérologie Endocrinienne, 114 rue Edouard Vaillant, Villejuif 94800, France
| | - Julien Hadoux
- Gustave Roussy, Service de Médecine Nucléaire et de Cancérologie Endocrinienne, 114 rue Edouard Vaillant, Villejuif 94800, France
| | - Michele Klain
- Gustave Roussy, Service de Médecine Nucléaire et de Cancérologie Endocrinienne, 114 rue Edouard Vaillant, Villejuif 94800, France
| | - Livia Lamartina
- Gustave Roussy, Service de Médecine Nucléaire et de Cancérologie Endocrinienne, 114 rue Edouard Vaillant, Villejuif 94800, France
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PET imaging in thyroid cancer. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00170-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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10
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Riley K, Anzai Y. Imaging of Treated Thyroid and Parathyroid Disease. Neuroimaging Clin N Am 2021; 32:145-157. [PMID: 34809835 DOI: 10.1016/j.nic.2021.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The thyroid and parathyroid glands are endocrine structures located in the visceral space of the infrahyoid neck. Imaging plays a critical role in the evaluation of patients with thyroid cancer, both in the pre and posttreatment setting. Disorders of thyroid function, that is, hyperthyroidism and hypothyroidism, are also fairly common, although imaging utilization is less frequent with these conditions. Parathyroid dysfunction results in disordered calcium metabolism. Imaging is frequently applied in the preoperative assessment of these patients undergoing parathyroidectomy; however, routine imaging in the postoperative setting is uncommon. Parathyroid carcinoma is rare; however, imaging may be used in the pre and posttreatment setting.
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Affiliation(s)
- Kalen Riley
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 N. University Boulevard, Room 0663, Indianapolis, IN 46202, USA.
| | - Yoshimi Anzai
- Department of Radiology and Imaging Sciences, University of Utah School of Medicine, 30 North 1900 East #1A071, Salt Lake City, UT 84132, USA. https://twitter.com/@yoshimianzai
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Advances in Functional Imaging of Differentiated Thyroid Cancer. Cancers (Basel) 2021; 13:cancers13194748. [PMID: 34638232 PMCID: PMC8507556 DOI: 10.3390/cancers13194748] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/17/2021] [Accepted: 09/21/2021] [Indexed: 12/25/2022] Open
Abstract
Simple Summary Since the 1940s, radioactive iodine has been used for functional imaging and for treating patients with differentiated thyroid cancer (DTC). During this long-lasting experience, the use of iodine isotopes evolved, especially during the last years due to improved knowledge of thyroid cancer biology and improved performances of imaging tools. The present review summarizes recent advances in the field of functional imaging and theragnostic approach of DTC. Abstract The present review provides a description of recent advances in the field of functional imaging that takes advantage of the functional characteristics of thyroid neoplastic cells (such as radioiodine uptake and FDG uptake) and theragnostic approach of differentiated thyroid cancer (DTC). Physical and biological characteristics of available radiopharmaceuticals and their use with state-of-the-art technologies for diagnosis, treatment, and follow-up of DTC patients are depicted. Radioactive iodine is used mostly with a therapeutic intent, while PET/CT with 18F-FDG emerges as a useful tool in the diagnostic management and complements the use of radioactive iodine. Beyond 18F-FDG PET/CT, other tracers including 124I, 18F-TFB and 68Ga-PSMA, and new methods such as PET/MR, might offer new opportunities in selecting patients with DTC for specific imaging modalities or treatments.
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Abstract
Primary thyroid cancers demonstrate distinct biological behaviors depending on their histologic characteristics. The ability to accumulate radioiodine by differentiated thyroid cancer cells is lost in primary aggressive, poorly differentiated and dedifferentiated tumor cells. PET imaging comes into play in these challenging situations where it can provide additive information to radioiodine scintigraphy and conventional imaging. This review focuses on the current guidelines and future prospects of PET imaging in thyroid cancers.
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13
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Cao Y, Zhong X, Diao W, Mu J, Cheng Y, Jia Z. Radiomics in Differentiated Thyroid Cancer and Nodules: Explorations, Application, and Limitations. Cancers (Basel) 2021; 13:2436. [PMID: 34069887 PMCID: PMC8157383 DOI: 10.3390/cancers13102436] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/13/2021] [Accepted: 05/16/2021] [Indexed: 02/05/2023] Open
Abstract
Radiomics is an emerging technique that allows the quantitative extraction of high-throughput features from single or multiple medical images, which cannot be observed directly with the naked eye, and then applies to machine learning approaches to construct classification or prediction models. This method makes it possible to evaluate tumor status and to differentiate malignant from benign tumors or nodules in a more objective manner. To date, the classification and prediction value of radiomics in DTC patients have been inconsistent. Herein, we summarize the available literature on the classification and prediction performance of radiomics-based DTC in various imaging techniques. More specifically, we reviewed the recent literature to discuss the capacity of radiomics to predict lymph node (LN) metastasis, distant metastasis, tumor extrathyroidal extension, disease-free survival, and B-Raf proto-oncogene serine/threonine kinase (BRAF) mutation and differentiate malignant from benign nodules. This review discusses the application and limitations of the radiomics process, and explores its ability to improve clinical decision-making with the hope of emphasizing its utility for DTC patients.
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Affiliation(s)
- Yuan Cao
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610040, China; (Y.C.); (X.Z.); (W.D.); (J.M.)
| | - Xiao Zhong
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610040, China; (Y.C.); (X.Z.); (W.D.); (J.M.)
| | - Wei Diao
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610040, China; (Y.C.); (X.Z.); (W.D.); (J.M.)
| | - Jingshi Mu
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610040, China; (Y.C.); (X.Z.); (W.D.); (J.M.)
| | - Yue Cheng
- Department of Radiology, West China Hospital of Sichuan University, Chengdu 610040, China;
| | - Zhiyun Jia
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610040, China; (Y.C.); (X.Z.); (W.D.); (J.M.)
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A Stepwise Approach Using Metastatic Lymph Node Ratio-Combined Thyroglobulin for Customization of [ 18F]FDG-PET/CT Indication to Detect Persistent Disease in Patients with Papillary Thyroid Cancer. Diagnostics (Basel) 2021; 11:diagnostics11050836. [PMID: 34066574 PMCID: PMC8148441 DOI: 10.3390/diagnostics11050836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 05/02/2021] [Accepted: 05/04/2021] [Indexed: 11/17/2022] Open
Abstract
We investigated whether an indication for [18F]FDG-PET/CT to detect FDG-avid persistent disease (PD) could be identified precisely using the extent of metastatic lymph nodes (MLNs) and serum thyroglobulin (Tg) in papillary thyroid cancer (PTC) patients. This retrospective study included 429 PTC patients who underwent surgery and radioactive iodine (RAI) therapy. [18F]FDG-PET/CT and serum Tg were evaluated just before RAI therapy. The MLN ratio (LNR) was defined as the ratio of the number of MLNs to the number of removed LNs. To derive the LNR-combined criteria, different Tg cut-off values for identifying the PET/CT-indicated group for PD detection were applied individually to subgroups initially classified based on LNR cut-off values. The cut-off values for serum Tg, the number of MLNs, and LNR for a PET/CT indication were 6.0 ng/mL, 5, and 0.51, respectively. Compared to a single parameter (serum Tg, total number of MLNs, and LNR), the LNR-combined criteria showed significantly superior diagnostic performance in detecting FDG-avid PD (p < 0.001). The diagnostic performance of PET/CT in detecting FDG-avid PD was significantly improved when the PET/CT-indicated group was identified through the LNR-combined criteria in a stepwise manner; this can contribute to a customized PET/CT indication in PTC patients.
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Imaging the Human Thyroid Using Three-Dimensional Diffuse Optical Tomography: A Preliminary Study. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11041670] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Thyroid cancer is usually diagnosed by ultrasound imaging and fine-needle aspiration biopsy. However, diagnosis of follicular thyroid carcinomas (FTC) is difficult because FTC lacks nuclear atypia and a consensus on histological interpretation. Diffuse optical tomography (DOT) offers the potential to diagnose FTC because it can measure tumor hypoxia, while image reconstruction of the thyroid is still challenging mainly due to the complex anatomical features of the neck. In this study, we attempted to solve this issue by creating a finite element model of the human neck excluding the trachea (a void region). By reconstruction of the absorption coefficients at three wavelengths, 3D tissue oxygen saturation maps of the human thyroid are obtained for the first time by DOT.
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Chaudhry IUH, Cheema A, Aqeel C, Al Haji Z, Alqahtani YA, Abbas A. Radical resection and improvised manubriosternal reconstruction technique for solitary manubriosternal metastasis from papillary thyroid cancer. Int J Surg Case Rep 2020; 76:278-281. [PMID: 33059205 PMCID: PMC7566078 DOI: 10.1016/j.ijscr.2020.09.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Thyroid papillary carcinoma rarely present as manubriosternum metastasis. The standard treatment for patients with metastatic disease is iodine ablation therapy. A surgical resection is a good option for patients with resectable limited bony metastasis. CASE PRESENTATION We report a case of a 50-year-old female with thyroid gland enlargement. Positron emission tomography scan (PET) showed a solitary manubriosternal metastasis. The patient underwent total thyroidectomy and claviculo-manubriosternal en-bloc resection and improvised reconstruction using Methyl methacrylate marlex mesh plate (MMS). Post-operative recovery was uneventful, and the patient received adjuvant radioactive iodine (RAI) treatment. At five year follow up patient remained disease-free. CONCLUSION In conclusion, we report a case of papillary carcinoma of thyroid with solitary manubriosternal metastasis treated with total thyroidectomy and radical en-bloc resection of clavicular heads, manubriosternal and reconstruction by our modified reconstruction technique, which provides the best MMS plate stability, cosmoses, and good disease-free survival. In solitary bony metastasis for thyroid cancer, radical resection followed by a RAI ablation, is the best treatment modality.
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Affiliation(s)
- Ikram Ul Haq Chaudhry
- Department of Thoracic Surgery and Pathology, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
| | - Ahsan Cheema
- Department of Thoracic Surgery and Pathology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Chaudhry Aqeel
- Department of Thoracic Surgery and Pathology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Zahra Al Haji
- Department of Thoracic Surgery and Pathology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Yousif A Alqahtani
- Department of Thoracic Surgery and Pathology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Ahmad Abbas
- Department of Thoracic Surgery and Pathology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
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Mourato FA, Almeida MA, Brito AET, Leal ALG, Almeida Filho P, Etchebehere E. FDG PET/CT versus somatostatin receptor PET/CT in TENIS syndrome: a systematic review and meta-analysis. Clin Transl Imaging 2020. [DOI: 10.1007/s40336-020-00390-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Vaz SC, Oliveira F, Herrmann K, Veit-Haibach P. Nuclear medicine and molecular imaging advances in the 21st century. Br J Radiol 2020; 93:20200095. [PMID: 32401541 PMCID: PMC10993229 DOI: 10.1259/bjr.20200095] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 04/24/2020] [Accepted: 04/27/2020] [Indexed: 12/14/2022] Open
Abstract
Currently, Nuclear Medicine has a clearly defined role in clinical practice due to its usefulness in many medical disciplines. It provides relevant diagnostic and therapeutic options leading to patients' healthcare and quality of life improvement. During the first two decades of the 21stt century, the number of Nuclear Medicine procedures increased considerably.Clinical and research advances in Nuclear Medicine and Molecular Imaging have been based on developments in radiopharmaceuticals and equipment, namely, the introduction of multimodality imaging. In addition, new therapeutic applications of radiopharmaceuticals, mainly in oncology, are underway.This review will focus on radiopharmaceuticals for positron emission tomography (PET), in particular, those labeled with Fluorine-18 and Gallium-68. Multimodality as a key player in clinical practice led to the development of new detector technology and combined efforts to improve resolution. The concept of dual probe (a single molecule labeled with a radionuclide for single photon emission computed tomography)/positron emission tomography and a light emitter for optical imaging) is gaining increasing acceptance, especially in minimally invasive radioguided surgery. The expansion of theranostics, using the same molecule for diagnosis (γ or positron emitter) and therapy (β minus or α emitter) is reshaping personalized medicine.Upcoming research and development efforts will lead to an even wider array of indications for Nuclear Medicine both in diagnosis and treatment.
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Affiliation(s)
- Sofia C. Vaz
- Nuclear Medicine - Radiopharmacology, Champalimaud Centre for
the Unknown, Champalimaud Foundation,
Lisbon, Portugal
| | - Francisco Oliveira
- Nuclear Medicine - Radiopharmacology, Champalimaud Centre for
the Unknown, Champalimaud Foundation,
Lisbon, Portugal
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen,
University of Duisburg-Essen,
Essen, Germany
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Mourato FA, Brito AET, Romão MSC, Santos RGG, de Almeida CA, de Almeida Filho PJ, Leal ALG. Use of PET/CT to aid clinical decision-making in cases of solitary pulmonary nodule: a probabilistic approach. Radiol Bras 2020; 53:1-6. [PMID: 32313329 PMCID: PMC7159041 DOI: 10.1590/0100-3984.2019.0034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Objective To determine the frequency with which 18F-FDG-PET/CT findings change the probability of malignancy classification of solitary pulmonary nodules. Materials and Methods This was a retrospective analysis of all 18F-FDG-PET/CT examinations performed for the investigation of a solitary pulmonary nodule between May 2016 and May 2017. We reviewed medical records and PET/CT images to collect the data necessary to calculate the pre-test probability of malignancy using the Swensen model and the Herder model. The probability of malignancy was classified as low if < 5%, intermediate if 5-65%, and high if > 65%. Cases classified as intermediate in the Swensen model were reclassified by the Herder model. Results We reviewed the records for 33 patients, of whom 17 (51.5%) were male. The mean age was 68.63 ± 12.20 years. According to the Swensen model, the probability of malignancy was intermediate in 23 cases (69.7%). Among those, the application of the Herder model resulted in the probability of malignancy being reclassified as low in 6 (26.1%) and as high in 8 (34.8%). Conclusion 18F-FDG-PET/CT was able to modify the probability of malignancy classification of a solitary pulmonary nodule in more than 50% of the cases evaluated.
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20
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[Imaging of medullary thyroid carcinoma]. Radiologe 2019; 59:992-1001. [PMID: 31367891 DOI: 10.1007/s00117-019-0575-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND About 10% of thyroid cancers are medullary thyroid carcinoma (MTC) and can occur sporadically, familially and in the context of type II multiple endocrine neoplasia (MEN). Imaging plays a pivotal role in screening family members and in diagnosis. DIAGNOSTIC METHODS Diagnosis is based on ultrasound (US), thyroid scintigraphy, serum calcitonin and carcinoembryonic antigen (CEA) as well as fine needle biopsy. High-resolution US is the most important imaging method for locoregional staging, combined with computed tomography (CT) of the mediastinum. Positron emission tomography (PET-CT) using 18-F-DOPA is particularly suited for suspected occult metastases in case of rising tumor markers in serum. FINDINGS AND COURSE OF DISEASE Diagnosis is made based on cytologic findings in a hypoechoic, cold thyroid nodule, combined with an elevation of serum calcitonin and CEA. US is the most important imaging modality during routine follow-up. CT is indicated for suspected mediastinal, lung, or liver metastases. CT should be replaced by MRI as early as possible to prevent significant cumulative radiation doses over time. RECENT CLINICAL DEVELOPMENTS Although MTC is curable by surgery only, owing to its radio- and chemoresistance, the disease will often progress only slowly, and even patients with metastases will frequently survive 10 years or longer. For more aggressive variants and late symptomatic stages, targeted drugs that have the potential to indicate stabilization or even a partial remission of the disease are under clinical investigation or already approved.
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Sharma SC, Sakthivel P, Raveendran S, Singh CA, Nakra T, Agarwal S. Anaplastic Carcinoma Thyroid in a Young Child – an Extremely Rare Occurrence. ACTA MEDICA (HRADEC KRÁLOVÉ) 2019; 61:150-152. [DOI: 10.14712/18059694.2018.134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Anaplastic thyroid carcinoma (ATC), one of the most aggressive malignancies, is extremely rare in childhood. We present a case of 5-yearold child who presented with rapidly progressing thyroid swelling and stridor, for which she underwent emergency tracheostomy and biopsy. Histopathological features were suggestive of ATC and the patient died within two months after diagnosis. ATC, though very rare in childhood, should be kept in the differential diagnoses of rapidly enlarging neck masses in children. To the best of our knowledge, this is the youngest case of ATC reported in literature.
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Lin YH, Tsai YC, Lin KJ, Der Lin J, Wang CC, Chen ST. Computer-Aided Diagnostic Technique in 2-Deoxy-2-[ 18F]fluoro-D-glucose-Positive Thyroid Nodule: Clinical Experience of 74 Non-thyroid Cancer Patients. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:108-121. [PMID: 30336966 DOI: 10.1016/j.ultrasmedbio.2018.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/01/2018] [Accepted: 09/03/2018] [Indexed: 06/08/2023]
Abstract
This study verified the value of a computer-aided diagnosis (CAD) technique assisting in ultrasonography (US) diagnosis of 2-deoxy-2-[18F]fluoro-D-glucose (18FDG)-avid thyroid incidentalomas on positron emission tomography. A total of 82 18FDG-avid thyroid incidentalomas from 74 non-thyroid cancer patients were retrospectively analyzed with respect to US and CAD parameters (anechoic area, hyper-echoic foci, hypo-echogenicity, heterogeneity, margin, taller-than-wide shape, eccentric area) and were compared with 38 other non-18FDG-avid nodules found in the same patient group. Fine-needle aspiration cytology or surgical intervention pathology was performed for diagnosis. No significant differences in nodule size or CAD parameters were found in 18FDG-avid nodules reported as benign, indeterminate or malignant. Significantly more taller-than-wide nodules were thyroid originating than metastatic (0.30 vs. 0.16, p < 0.05). Nevertheless, combined CAD and positron emission tomography/computed tomography scores and a discrimination point of 4 resulted in a sensitivity of 75% and a specificity of 80% in prediction of incidentaloma benignity.
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Affiliation(s)
- Yi-Hsuan Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | | | - Kun Ju Lin
- Departments of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Jen- Der Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Chih-Ching Wang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan
| | - Szu-Tah Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan.
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Ziai H, Lebo NL, Kielar AZ, Odell MJ. Can Thyroid Ultrasonography Predict Substernal Extension or Tracheal Compression in Goiters? Can Assoc Radiol J 2018; 69:422-429. [PMID: 30390961 DOI: 10.1016/j.carj.2018.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 07/24/2018] [Accepted: 07/25/2018] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To determine whether an ultrasonography (US)-defined thyroid volume can accurately predict substernal extension or tracheal narrowing. METHODS After research ethics approval, we identified patients with thyroid nodules investigated with both US and computed tomography (CT). Reviewers assigned scores for both substernal extension and tracheal compression on CT using pre-established classification systems. Statistical analysis with receiver operating characteristic curve analysis was performed to find the US-determined thyroid volume thresholds that correlated with each substernal extension and tracheal compression. RESULTS This study included 120 patients (mean age 63.4 years; SD ± 15.9; 67% female). Thirty-five patients (29%) had substernal extension. The mean US total thyroid gland volume in patients with and without substernal extension were 92.4 and 37.6 cm3, respectively (P < .001). 86% of patients with substernal extension had tracheal narrowing vs. 27% of patients without substernal extension (P < .0001). A cutoff dominant gland volume of ≥37.5 cm3 showed 83% sensitivity and 79% specificity for substernal extension (area under the curve [AUC] = 0.84). A total thyroid gland volume threshold of ≥37.8 cm3 showed 89% sensitivity and 87% specificity for any degree of tracheal narrowing (AUC = 0.90). CONCLUSIONS This study suggests that US volumes may be used as a predictor to identify those patients with thyroid enlargement who are most at risk of substernal extension and tracheal compression and who may benefit from preoperative CT imaging for optimal surgical and anesthetic planning.
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Affiliation(s)
- Hedyeh Ziai
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Nicole L Lebo
- Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Ania Z Kielar
- Department of Medical Imaging, University of Ottawa, Ontario, Canada
| | - Michael J Odell
- Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, Ottawa, Ontario, Canada.
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Anaplastic Thyroid Cancer With Extensive Skeletal Muscle Metastases on 18F-FDG PET/CT. Clin Nucl Med 2018; 43:e113-e114. [PMID: 29356736 DOI: 10.1097/rlu.0000000000001968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A 61-year-old woman with newly diagnosed anaplastic thyroid cancer and known metastases to the brain, lungs, and adrenal glands complained of groin muscle pain. F-FDG PET/CT was performed to assess for extent of disease and showed extensive hypermetabolic lesions throughout the skeletal musculature concerning for metastatic disease. As this would be a very rare presentation for anaplastic thyroid carcinoma, a biopsy of the left gluteal muscle was conducted. Pathology demonstrated anaplastic thyroid carcinoma, metastatic to skeletal muscle.
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25
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Chen SW, Chen YK. High CEA levels in a case of resected colorectal cancer: delayed diagnosis of metachronous medullary thyroid cancer. World J Surg Oncol 2017; 15:230. [PMID: 29284496 PMCID: PMC5747095 DOI: 10.1186/s12957-017-1303-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 12/18/2017] [Indexed: 12/27/2022] Open
Abstract
Background Carcinoembryonic antigen (CEA) is one of the most widely used tumor markers, and its value in the surveillance of post-operative colorectal cancer is well established. Fluorodeoxyglucose-positron emission tomography (FDG-PET) has been clinically used in colorectal cancer imaging including preoperative staging, evaluation of therapeutic response, detection of disease recurrence, and investigation of unexplained rising tumor markers. Case presentation We report a case of resected colorectal cancer presented with rising CEA levels in 5 years, and FDG-PET revealed no definitive evidence of recurrence except abnormal focal FDG uptake in the right thyroid lobe. However, fine needle aspiration cytology (FNAC) of the thyroid nodule showed negative for malignancy. Progressively rising CEA levels were noted over the following 5 years, but serial follow-up examinations did not find evidence of recurrence. Fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) was performed subsequently and again showed focal FDG uptake in the right thyroid lobe. This time, FNAC revealed positive for malignancy, in favor of medullary thyroid carcinoma (MTC). The patient underwent total thyroidectomy and modified radical neck dissection, and MTC with cervical nodal metastasis (pT3N1) was diagnosed. He had cervical lymph nodes recurrence 2 years later, which was resected. Conclusions This case reminded us that FDG-PET/CT may detect occult tumors resulting in CEA elevation other than colorectal cancer. Moreover, FNA has a higher false negative rate in detecting MTC than other forms of thyroid cancer. Repeat FNAC for the initial negative cytology result and measure of serum calcitonin for the early MTC detection could be more helpful to avoid the delay in MTC diagnosis.
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Affiliation(s)
- Shih-Wei Chen
- Department of Nuclear Medicine, Shin Kong Wu Ho Su Memorial Hospital, No. 95, Wen-Chang Rd., Shih-Lin District, Taipei, 11101, Taiwan.
| | - Yen-Kung Chen
- School of Medicine, Taipei Medical University and Fu Jen Catholic University, New Taipei City, Taiwan.,Department of Nuclear Medicine and PET Center, Shin Kong Wu Ho-Su Memorial Hospital, No. 95, Wen-Chang Rd., Shih-Lin District, Taipei, Taiwan
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Gionfrida L, Roginska A. A Novel Sonification Approach to Support the Diagnosis of Alzheimer's Dementia. Front Neurol 2017; 8:647. [PMID: 29270150 PMCID: PMC5725407 DOI: 10.3389/fneur.2017.00647] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 11/16/2017] [Indexed: 11/22/2022] Open
Abstract
Alzheimer’s disease is the most common neurodegenerative form of dementia that steadily worsens and eventually leads to death. Its set of symptoms include loss of cognitive function and memory decline. Structural and functional imaging methods such as CT, MRI, and PET scans play an essential role in the diagnosis process, being able to identify specific areas of cerebral damages. While the accuracy of these imaging techniques increases over time, the severity assessment of dementia remains challenging and susceptible to cognitive and perceptual errors due to intra-reader variability among physicians. Doctors have not agreed upon standardized measurement of cell loss used to specifically diagnose dementia among individuals. These limitations have led researchers to look for supportive diagnosis tools to enhance the spectrum of diseases characteristics and peculiarities. Here is presented a supportive auditory tool to aid in diagnosing patients with different levels of Alzheimer’s. This tool introduces an audible parameter mapped upon three different brain’s lobes. The motivating force behind this supportive auditory technique arise from the fact that AD is distinguished by a decrease of the metabolic activity (hypometabolism) in the parietal and temporal lobes of the brain. The diagnosis is then performed by comparing metabolic activity of the affected lobes to the metabolic activity of other lobes that are not generally affected by AD (i.e., sensorimotor cortex). Results from the diagnosis process compared with the ground truth show that physicians were able to categorize different levels of AD using the sonification generated in this study with higher accuracy than using a standard diagnosis procedure, based on the visualization alone.
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Affiliation(s)
- Letizia Gionfrida
- Centre of Performance Science, Royal College of Music, London, United Kingdom.,BICV Group, Bioengineering Department, Faculty of Engineering, Imperial College London, London, United Kingdom
| | - Agnieszka Roginska
- Music and Audio Research Laboratory, Music Technology, New York University, New York, NY, United States.,Division of Nuclear Medicine, Department of Radiology, NYU School of Medicine, New York, NY, United States
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Ginat DT, Avram AM. Chapter 4 Thyroid Malignancy: Staging and Restaging. Semin Ultrasound CT MR 2017; 38:495-505. [PMID: 29031366 DOI: 10.1053/j.sult.2017.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Determining the extent of disease is necessary for guiding the management of thyroid carcinomas. Diagnostic imaging, including ultrasound, computed tomography, magnetic resonance imaging, and nuclear medicine scans, plays an essential role in staging and restaging of thyroid carcinomas. This article reviews the approaches and imaging findings for evaluating the primary tumor, regional lymph node metastases, and distant metastases. In addition, potential pitfalls are discussed and depicted.
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Affiliation(s)
- Daniel Thomas Ginat
- Department of Radiology, University of Chicago, Pritzker School of Medicine, Chicago, IL.
| | - Anca M Avram
- Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, MI
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Hamilton SN, Tran E, Berthelet E, Wu J. The role of external beam radiation therapy in well-differentiated thyroid cancer. Expert Rev Anticancer Ther 2017; 17:905-910. [PMID: 28750593 DOI: 10.1080/14737140.2017.1361324] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
INTRODUCTION This review article explores the use of external beam radiotherapy (EBRT) in well differentiated thyroid cancer. Areas covered: The published literature on EBRT for advanced pT4 disease and macroscopic unresectable disease to improve locoregional control is reviewed. EBRT techniques, volumes and doses are discussed in detail. The potential acute and late toxicities of EBRT are discussed in the context of the published literature. The use of EBRT for patients with metastatic disease is also described. Expert commentary: There is good retrospective evidence for EBRT in the setting of unresectable gross residual well-differentiated thyroid cancer as this can result in long-term local control. However, the benefit of EBRT in patients with locally advanced disease that is completely resected is less clear. The use of EBRT for these patients requires careful consideration of age, pathologic factors, comorbidities and patient preference, preferably by a multi-disciplinary team.
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Affiliation(s)
| | - Eric Tran
- a BC Cancer Agency , Vancouver , Canada
| | | | - Jonn Wu
- a BC Cancer Agency , Vancouver , Canada
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Garg G, Benchekroun MT, Abraham T. FDG-PET/CT in the Postoperative Period: Utility, Expected Findings, Complications, and Pitfalls. Semin Nucl Med 2017; 47:579-594. [PMID: 28969758 DOI: 10.1053/j.semnuclmed.2017.07.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
FDG-PET/CT as a modality is increasingly used for detection of recurrence and for restaging in patients with clinical suspicion of malignancy, as well as in patients with elevated tumor markers. However, there are many pitfalls in the interpretation of these scans when the studies are performed after some treatment. Some of these are attributed to normal physiological distribution and are compounded when there are inflammatory changes occurring after surgery. The body's inherent response to the surgical insult results in this inflammation. In addition, there are also complications that can happen following surgery, causing increased FDG uptake. Despite various fallacies, FDG-PET/CT provides valuable information in evaluation of residual and recurrent malignant disease. In this article, we aim to describe some of these postsurgical changes secondary to inflammation, common surgical complications, and finally, the utility of FDG-PET/CT in these patients to detect recurrent disease, even in the background of postsurgical changes.
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Affiliation(s)
- Gunjan Garg
- Division of Nuclear Medicine, Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - Mohammed Taoudi Benchekroun
- Division of Nuclear Medicine, Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY
| | - Tony Abraham
- Division of Nuclear Medicine, Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY.
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Eweida AM, Sakr MF, Hamza Y, Khalil MR, Gabr E, Koraitim T, Al-Wagih HF, Abo-Elwafa W, Ezzat Abdel-Aziz T, Diab AA, El-Sabaa B, Nabawi AS. Level I lymph node involvement in patients with N1b papillary thyroid carcinoma: a prospective study. Eur Arch Otorhinolaryngol 2017; 274:1951-1958. [PMID: 27999997 DOI: 10.1007/s00405-016-4423-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 12/07/2016] [Indexed: 02/08/2023]
Abstract
Most of the studies on the incidence, pattern, and predictive factors of lymph node (LN) metastasis with papillary thyroid carcinoma (PTC) have been performed retrospectively and no common consensus has been reached regarding the predictors for the involvement of level I LNs. This study was conducted prospectively to determine the incidence and the possible predictors of level I involvement in N1b PTC patients. The study included 30 consecutive patients with N1b stage of PTC. All the patients underwent neck dissection (ND) including level I. The relation between involvement of level I LNs and various clinicopathological variables was studied. Unilateral neck dissection was performed in 24 patients and bilateral neck dissection in six patients leading to 36 NDs. Level I was excised in all patients, with five specimens (14%) positive for metastasis. Levels II, III, IV, V, VI, and VII were positive in 52.8, 58.3, 58.3, 33.3, 63, and 22.2%, respectively. Level I involvement was significantly related to the number of lymph node levels affected (p = 0.003) and macroscopic extranodal invasion (p = 0.04). It was not related to the involvement of other individual levels, gender, age, size of the largest thyroid nodule, size of the largest LN involved, or histo-pathological variant of the tumor. This study suggests that including level I in therapeutic neck dissection for N1b PTC patients might be recommended in selected cases of multiple level involvement and macroscopic extranodal invasion requiring sacrifice of internal jugular vein, spinal accessory nerve, or sternomastoid muscle.
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Affiliation(s)
- Ahmad M Eweida
- Head, Neck and Endocrine Surgery Unit (HNESU), Department of Surgery, Faculty of Medicine, University of Alexandria, Alexandria, Egypt.
- Department of Plastic and Reconstructive Surgery, University of Heidelberg, Heidelberg, Germany.
| | - Mahmoud F Sakr
- Head, Neck and Endocrine Surgery Unit (HNESU), Department of Surgery, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Yasser Hamza
- Head, Neck and Endocrine Surgery Unit (HNESU), Department of Surgery, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Mohamed R Khalil
- Head, Neck and Endocrine Surgery Unit (HNESU), Department of Surgery, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Essam Gabr
- Head, Neck and Endocrine Surgery Unit (HNESU), Department of Surgery, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Tarek Koraitim
- Head, Neck and Endocrine Surgery Unit (HNESU), Department of Surgery, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Hatem F Al-Wagih
- Head, Neck and Endocrine Surgery Unit (HNESU), Department of Surgery, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Waleed Abo-Elwafa
- Head, Neck and Endocrine Surgery Unit (HNESU), Department of Surgery, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Tarek Ezzat Abdel-Aziz
- Head, Neck and Endocrine Surgery Unit (HNESU), Department of Surgery, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
- Department of Endocrine Surgery, University College London, London, UK
| | - Ahmed A Diab
- Head, Neck and Endocrine Surgery Unit (HNESU), Department of Surgery, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Basma El-Sabaa
- Department of Pathology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Aman S Nabawi
- Head, Neck and Endocrine Surgery Unit (HNESU), Department of Surgery, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
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Araz M, Çayır D. 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography for Other Thyroid Cancers: Medullary, Anaplastic, Lymphoma and So Forth. Mol Imaging Radionucl Ther 2017; 26:1-8. [PMID: 28291004 PMCID: PMC5350500 DOI: 10.4274/mirt.60783] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Positron emission tomography/computed tomography (PET/CT) with 18F-fluorodeoxyglucose (FDG) is used in staging, restaging, and evaluation of therapy response in many cancers as well as differentiated thyroid carcinomas especially in non-iodine avid variants. Its potential in less frequent thyroid tumors like medullary, anaplastic thyroid cancers, thyroid lymphoma and metastatic tumors of the thyroid however, is not well established yet. The aim of this review is to provide an overview on the recent applications and indications of 18F-FDG PET/CT in these tumors and to focus on the controversies in the clinical setting.
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Affiliation(s)
- Mine Araz
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Clinic of Nuclear Medicine, Ankara, Turkey Phone: +90 532 666 73 13 E-mail:
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Abadi P, Johansen A, Godballe C, Gerke O, Høilund-Carlsen PF, Thomassen A. 18F-FDG PET/CT to differentiate malignant necrotic lymph node from benign cystic lesions in the neck. Ann Nucl Med 2016; 31:101-108. [PMID: 27921286 DOI: 10.1007/s12149-016-1142-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 10/15/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Patients presenting with cystic lesions in the neck without obvious signs of malignancy constitute a diagnostic challenge since fine needle aspiration is often insufficient and a diagnosis may not be reached until surgical resection/biopsy is performed. The differential diagnosis of a cystic cervical mass comprises a variety of benign conditions, but malignancy must be ruled out. We examined the diagnostic performance of fluorine-18 fluorodeoxyglucose (18F-FDG) PET/CT to identify malignancy. METHODS We retrospectively included consecutive patients referred from the Department of ENT Head and Neck Surgery for 18F-FDG PET/CT-scans because of a solitary neck cyst. Scan results were compared to histopathology and follow-up. RESULTS The study comprised 58 patients. Twenty patients (34%) were diagnosed with cancer during follow-up. PET/CT suggested malignancy in 34 patients (19 true positive, 15 false positive) and showed no malignancy in 24 (23 true negative, 1 false negative). The sensitivity, specificity, accuracy, positive and negative predictive values were 95% (76-99%), 61% (45-74%), 72% (60-82%), 56% (39-71%), and 96% (80-99%), respectively (95% confidence intervals in brackets). The primary tumor was identified in 14 out of the 20 patients with confirmed cancer. Increased metabolism, as evaluated by PET, was the only imaging characteristic among several others, which associated independently with malignancy in the cystic neck lesions, odds ratio 1.27 (1.07-1.50), p = 0.006. CONCLUSION 18F-FDG PET/CT could reliably rule out malignancy (NPV 96%), albeit with a high frequency of false positive scans, requiring further diagnostic work-up. Increased metabolism was the best imaging parameter to differentiate between malignant and benign lesions.
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Affiliation(s)
- Peymaneh Abadi
- Department of Nuclear Medicine, Odense University Hospital, Søndre Boulevard 29, 5000, Odense C, Denmark.
| | - Allan Johansen
- Department of Nuclear Medicine, Odense University Hospital, Søndre Boulevard 29, 5000, Odense C, Denmark
| | - Christian Godballe
- Department of ENT Head and Neck Surgery, Odense University Hospital, Søndre Boulevard 29, 5000, Odense C, Denmark
| | - Oke Gerke
- Department of Nuclear Medicine, Odense University Hospital, Søndre Boulevard 29, 5000, Odense C, Denmark
- Centre of Health Economics Research, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | | | - Anders Thomassen
- Department of Nuclear Medicine, Odense University Hospital, Søndre Boulevard 29, 5000, Odense C, Denmark
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Diffusion-Weighted Imaging Using a Readout-Segmented, Multishot EPI Sequence at 3 T Distinguishes between Morphologically Differentiated and Undifferentiated Subtypes of Thyroid Carcinoma-A Preliminary Study. Transl Oncol 2016; 9:403-410. [PMID: 27661405 PMCID: PMC5035355 DOI: 10.1016/j.tranon.2016.09.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 08/29/2016] [Accepted: 09/01/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Thyroid carcinomas represent the most frequent endocrine malignancies. Recent studies were able to distinguish malignant from benign nodules of the thyroid gland with diffusion-weighted imaging (DWI). Although this differentiation is undoubtedly helpful, presurgical discrimination between well-differentiated and undifferentiated carcinomas would be crucial to define the optimal treatment algorithm. Therefore, the aim of this study was to investigate if readout-segmented multishot echo planar DWI is able to differentiate between differentiated and undifferentiated subtypes of thyroid carcinomas. PATIENTS AND METHODS Fourteen patients with different types of thyroid carcinomas who received preoperative DWI were included in our study. In all lesions, apparent diffusion coefficient (ADC)min, ADCmean, ADCmax, and D were estimated on the basis of region of interest measurements after coregistration with T1-weighted, postcontrast images. All tumors were resected and analyzed histopathologically. Ki-67 index, p53 synthesis, cellularity, and total and average nucleic areas were estimated using ImageJ version 1.48. RESULTS Analysis of variance revealed a statistically significant difference in ADCmean values between differentiated and undifferentiated thyroid carcinomas (P=.022). Spearman Rho calculation identified significant correlations between ADCmax and cell count (r=0.541, P=.046) as well as between ADCmax and total nuclei area (r=0.605, P=.022). CONCLUSION DWI can distinguish between differentiated and undifferentiated thyroid carcinomas.
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Fujii T, Yajima R, Tatsuki H, Kuwano H. Implication of 18F-fluorodeoxyglucose uptake by affected lymph nodes in cases with differentiated thyroid cancer. Mol Clin Oncol 2016; 5:247-251. [PMID: 27600496 DOI: 10.3892/mco.2016.958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 03/16/2016] [Indexed: 11/06/2022] Open
Abstract
In this study, we evaluated the usefulness of positron emission tomography using 18F-fluorodeoxyglucose (FDG-PET) to detect metastatic lymph nodes in differentiated thyroid cancer. We also investigated whether certain factors, including the size of the metastasis to the lymph nodes, are associated with FDG avidity. A total of 22 consecutive patients with differentiated thyroid cancer who underwent FDG-PET preoperatively were enrolled in this study. Lymph node metastasis was diagnosed in the final pathology in 10 of the 22 patients (45.5%). The mean maximum standardized uptake value of the metastatic lymph nodes was 4.53 (range, 0-23.5). The 22 cases with differentiated thyroid cancer were divided into two groups based on lymph node metastasis. Clinicopathological variables other than FDG uptake of metastatic lymph nodes were not predictors of lymph node metastasis of thyroid cancer. The sensitivity, specificity, overall accuracy and false-negative rates of preoperative FDG-PET in the prediction of lymph node status were 40.0, 100, 72.7 and 60.0%, respectively. The false-positive rate of FDG-PET evaluation was 0%. The mean largest dimension of metastasis was 23.0 mm for FDG-positive cases and 10.9 mm for FDG-negative cases. There was a marked difference in the size of metastases between FDG-positive and -negative cases; however, even in patients with node metastasis >10 mm, the false-negative rate was 50.0%. Therefore, FDG-PET imaging was not found to be sufficient for the evaluation of lymph node status, particularly in cases with small metastases. Our findings indicate that preoperative FDG-PET evaluation of the lymph nodes cannot be considered predictive of the final pathology.
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Affiliation(s)
- Takaaki Fujii
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma 371-8511, Japan
| | - Reina Yajima
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma 371-8511, Japan
| | - Hironori Tatsuki
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma 371-8511, Japan
| | - Hiroyuki Kuwano
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma 371-8511, Japan
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Kelil T, Keraliya AR, Howard SA, Krajewski KM, Braschi-Amirfarzan M, Hornick JL, Ramaiya NH, Tirumani SH. Current Concepts in the Molecular Genetics and Management of Thyroid Cancer: An Update for Radiologists. Radiographics 2016; 36:1478-1493. [DOI: 10.1148/rg.2016150206] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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The role of 18F-FDG PET/CT in the follow-up of well-differentiated thyroid cancer with negative thyroglobulin but positive and/or elevated antithyroglobulin antibody. Nucl Med Commun 2016; 37:577-82. [DOI: 10.1097/mnm.0000000000000480] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Jo I, Zeon SK, Kim SH, Kim HW, Kang SH, Kwon SY, Kim SJ. Correlation of Primary Tumor FDG Uptake with Clinicopathologic Prognostic Factors in Invasive Ductal Carcinoma of the Breast. Nucl Med Mol Imaging 2014; 49:19-25. [PMID: 25774234 DOI: 10.1007/s13139-014-0296-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 08/24/2014] [Accepted: 08/25/2014] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate the correlation of primary tumor FDG uptake to clinicopathological prognostic factors in invasive ductal carcinoma of the breast. METHODS We retrospectively reviewed 136 of 215 female patients with pathologically proven invasive ductal breast cancer from January 2008 to December 2011 who underwent F-18 FDG PET/CT for initial staging and follow-up after curative treatment with analysis of estrogen receptor (ER), progesterone receptor (PR) and human epithelial growth factor receptor 2 (HER2). The maximum standardized uptake value (SUVmax) of the primary breast tumor was measured and compared with hormonal receptor and HER2 overexpression status. RESULTS The high SUVmax of primary breast tumors is significantly correlated with the clinicopathological factors: tumor size, histologic grade, TNM stage, negativity of ER, negativity of PR, HER2 overexpression and triple negativity. The recurrent group with non-triple negative cancer had a higher SUVmax compared with the non-recurrent group, though no significant difference in FDG uptake was noted between the recurrence and non-recurrent groups in subjects with triple-negative cancer. Lymph node involvement was the independent risk factor for cancer recurrence in the multivariate analysis. CONCLUSIONS In conclusion, high FDG uptake in primary breast tumors is significantly correlated with clinicopathological factors, such as tumor size, histologic grade, TNM stage, negativity of the hormonal receptor, HER2 overexpression and triple negativity. Therefore, FDG PET/CT is a helpful prognostic tool to direct the further management of patients with breast cancer.
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Affiliation(s)
- I Jo
- Department of Nuclear Medicine, Keimyung University, School of Medicine, Daegu, Republic of Korea
| | - Seok Kil Zeon
- Department of Nuclear Medicine, Bundang Jesaeng General Hospital, Seohyeon-dong 255-2, Seongnam, Republic of Korea
| | - Sung Hoon Kim
- Department of Nuclear Medicine, Keimyung University, School of Medicine, Daegu, Republic of Korea
| | - Hae Won Kim
- Department of Nuclear Medicine, Keimyung University, School of Medicine, Daegu, Republic of Korea
| | - Sun Hee Kang
- Department of Surgery, Keimyung University, School of Medicine, Daegu, Republic of Korea
| | - Sun Young Kwon
- Department of Pathology, Keimyung University, School of Medicine, Daegu, Republic of Korea
| | - Su Jin Kim
- Department of Anesthesiology and Pain Medicine, Dongguk University, School of Medicine, Gyeongju, Republic of Korea
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Antoniou AJ, Marcus C, Subramaniam RM. Value of Imaging in Head and Neck Tumors. Surg Oncol Clin N Am 2014; 23:685-707. [DOI: 10.1016/j.soc.2014.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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