18F-fluorodeoxyglucose positron emission tomography and computed tomography in anaplastic thyroid cancer

Abstract

Purpose  

Our aim was to evaluate in anaplastic thyroid carcinoma (ATC) patients the value of ¹⁸F-FDG PET/CT compared with total body computed tomography (CT) using intravenous contrast material for initial staging, prognostic
assessment, therapeutic monitoring and follow-up.

Methods  

Twenty consecutive ATC patients underwent PET/CT for initial staging. PET/CT was performed again during follow-up. The gold
standard was progression on imaging follow-up (CT or PET/CT) or confirmation with another imaging modality.

Results  

A total of 265 lesions in 63 organs were depicted in 18 patients. Thirty-five per cent of involved organs were demonstrated
only with PET/CT and one involved organ only with CT. In three patients, the extent of disease was significantly changed with
PET/CT that demonstrated unknown metastases. Initial treatment modalities were modified by PET/CT findings in 25% of cases.
The volume of FDG uptake (?300 ml) and the intensity of FDG uptake (SUV_max ?18) were significant prognostic factors for survival. PET/CT permitted an earlier assessment of tumour response to treatment
than CT in 4 of the 11 patients in whom both examinations were performed. After treatment with combined radiotherapy and chemotherapy,
only the two patients with a negative control PET/CT had a confirmed complete remission at 14 and 38 months; all eight patients
who had persistent FDG uptake during treatment had a clinical recurrence and died.

Conclusion  

FDG PET/CT appears to be the reference imaging modality for ATC at initial staging and seems promising in the early evaluation
of treatment response and follow-up.

• Content Type Journal Article
• DOI 10.1007/s00259-010-1570-6
• Authors
  • Thomas Poisson, Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France
  • Desiree Deandreis, Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France
  • Sophie Leboulleux, Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France
  • Francois Bidault, Department of Radiology, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France
  • Guillaume Bonniaud, Department of Medical Physics, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France
  • Sylvain Baillot, Department of Epidemiology, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France
  • Anne Auperin, Department of Epidemiology, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France
  • Abir Al Ghuzlan, Department of Pathology, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France
  • Jean-Paul Travagli, Department of Endocrine Surgery, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France
  • Jean Lumbroso, Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France
  • Eric Baudin, Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France
  • Martin Schlumberger, Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France

• Journal European Journal of Nuclear Medicine and Molecular Imaging
• Online ISSN 1619-7089
• Print ISSN 1619-7070