Session: SAT 270-310-Thyroid Neoplasia (posters)
Poster Board SAT 301
Material and methods:
Five patients, aged 56.6 ±9.6 (45 – 70) years, who were initially successfully treated with surgery and radioiodine, were qualified to the FDG-PET/CT after rhTSH administration due to suspicion of the DTC recurrence. Three out of 5 patients suffered from follicular cancer, in 2 subjects follicular variant of papillary cancer was diagnosed (TNM staging: pT1b N0Mx to pT3 N0Mx). All patients had the repeated slightly elevated Tg levels and negative results of both 131I post therapeutic scans and unstimulated FDG-PET/CT scans. Maximal values of l-thyroxin suppressed and rhTSH stimulated Tg were 12.9 ±7.8 ng/ml and 52.7±16.3 ng/ml respectively; a-Tg antibodies were negative in each case.
Results: rhTSH stimulated FDG-PET/CT scans were positive in 4 out of 5 patients.
rhTSH FDG-PET/CT result influenced further patients management as follows: patient 1 (female): 2 bone metastases were detected and successfully treated with external beam, remission; patient 2 (female): single pulmonary meta (9/10 lung segment) was found and confirmed histopathologically; patient 3 (male): 4 mm focal FDG uptake in FTC recurrence in the neck fascia was detected and removed; patient 4 (female): focal tracer uptake in the neck region was found, due to contraindication to surgery and increasing thyroglobulin levels thyroid inhibitor treatment was applied; patient 5 (male): negative scan, the decrease of Tg level was observed.
Conclusions: rhTSH administration improves the sensitivity of FDG-PET/CT in selected DTC patients enabling to optimize the treatment with a more effective strategy. Further studies should be undertaken to validate the clinical usefulness of this procedure.
Nothing to Disclose: AH, MB, MT, AB, AS, MK
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