F-18 FDG PET/CT imaging in the diagnostic work-up of thyroid cancer patients with high serum thyroglobulin, negative I-131 whole body scan and suppressed thyrotropin: 8-year experience.

OBJECTIVE: Fluorodeoxyglucose positron emission tomography/computed tomography imaging in the follow-up of patients with differentiated thyroid carcinoma who have high serum thyroglobulin, negative iodine-131 whole body scan and suppressed thyrotropin. PATIENTS AND METHODS: A total of 90 patients (31 male and 59 female) with differentiated thyroid carcinoma who have high serum thyroglobulin and negative iodine-131 whole body scan were included in the study between July 2006 and March 2014. All patients had undergone surgery (total thyroidectomy ± lymph node dissection) followed by iodine-131 ablation. Of the patients, 82 had papillary thyroid carcinoma and 8 follicular thyroid carcinoma. Serum thyrotropin was suppressed (< 2 µ IU/ml) during the Fluor-18 fluorodeoxyglucose positron emission tomography/computed tomography imaging procedure. RESULTS: The overall sensitivity of fluor-18 fluorodeoxyglucose positron emission tomography/computed tomography imaging in the detection of metastasis of differentiated thyroid cancer was 84.8%, the specificity 79.1%, respectively. The sensitivity and specificity of fluor-18 fluorodeoxyglucose positron emission tomography/computed tomography imaging in classic type of papillary cancer was 83.3% and 54.5%, respectively. The corresponding figures for the tall cell variant was 85.7% and 87.5%, respectively. The difference between the two histological subtypes was statistically significant (p < 0.05). CONCLUSIONS: Our results suggest that fluor-18 fluorodeoxyglucose positron emission tomography/computed tomography imaging could be a valuable test for the routine follow-up of patients with differentiated thyroid carcinoma.

Blood-pool SPECT in addition to bone SPECT in the viability assessment in mandibular reconstruction.

INTRODUCTION: The assessment of the postoperative viability of vascularized and non-vascularized grafts used in the reconstruction of mandibular defects due to trauma and surgical reasons is a major problem in maxillofacial surgery. AIM: In the present study, we evaluated the feasibility and image quality of blood-pool SPECT, which is used for the first time in the literature here in the assessment of mandibular reconstruction, in addition to non-invasive bone scintigraphy and bone SPECT. We also evaluated whether it would be useful in clinical prediction. PATIENTS AND METHODS: Micro-vascularized and non-vascularized bone grafts were used in 12 Syrian men with maxillofacial trauma. Between days 5-7 after surgery, three-phase bone scintigraphy, blood-pool SPECT and delayed bone SPECT scans were performed. After month 6, the patients were assessed by control CT scans. RESULTS: Of the non-vascularized grafts, one graft was reported as non-viable at week one. At month 6, graft resorption was demonstrated on the CT images. The remaining non-vascularized grafts and all of the micro-vascularized grafts were considered to be viable according to delayed bone SPECT and blood-pool SPECT images. However, only the anterior and posterior ends could be clearly assessed on delayed SPECT images, while blood-pool SPECT images allowed the clear assessment of the entire graft. CONCLUSIONS: The combined use of blood-pool and delayed SPECT scans could allow for better assessment of graft viability in the early period, and can provide more detailed information to clinicians about prognosis in the follow-up of patients undergoing mandibular graft reconstruction.

Lung metastases in patients with differentiated thyroid carcinoma and evaluation of response to radioiodine therapy

Introducción La localización más común de las metástasis a distancia en tumores diferenciados de tiroides es el pulmón. En este estudio se pretende determinar la proporción de metástasis pulmonares en el cáncer diferenciado de tiroides y su respuesta a la terapia con radioyodo. Material y métodos. Quinientos cuarenta y dos pacientes con cáncer diferenciado de tiroides fueron incluidos en este estudio. Se administraron altas dosis de 131I a los pacientes con metástasis pulmonares. La respuesta a la terapia se evaluó con estudios con 131I y niveles de tiroglobulina estimulada al menos 6 meses después de la terapia inicial. Resultados. Se detectaron metástasis pulmonares en 17 (3,1%) de los 542 pacientes. Tras la terapia con dosis altas de 131I se observó respuesta completa en 5 (29,4%), respuesta parcial en 3 (17,6%) y no se obtuvo respuesta en 9 (53%) de los pacientes. Conclusión. Aunque las metástasis pulmonares en los cánceres diferenciados de tiroides son raras, son más frecuentes en edades avanzadas y en varones. Altas dosis de 131I pueden ser beneficiosas, aunque habitualmente esta terapia debe repetirse(AU)

Introduction. The most common site of metastases in differentiated thyroid carcinomas is the lungs. In our study, we aimed to determine the ratios of lung metastases in patients with differentiated thyroid carcinoma and response to radioiodine therapy. Material and methods. A total of 542 patients with differentiated thyroid carcinoma who were admitted to our clinic were included in the study. High doses of 131I were administered to the patients with lung metastases. Response to therapy were evaluated with 131I scans and stimulated serum Tg levels were examined at least 6 months after therapy. Results. Lung metastases were detected in 17 (3.1%) of 542 patients with differentiated thyroid carcinoma. Of these patients to whom high doses of 131I therapy were administered, complete response to therapy was obtained in 5 (29.4%), partial response was obtained in 3 (17.6%) and no response could be obtained in 9 (53%) patients. Conclusion. Although lung metastases from differentiated thyroid carcinomas are rare, those are more common in advanced ages and in males. High doses of 131I therapy may be partially beneficial in these patients. Thus repetition of therapy is frequently required(AU)

Lung metastases in patients with differentiated thyroid carcinoma and evaluation of response to radioiodine therapy.

INTRODUCTION: The most common site of metastases in differentiated thyroid carcinomas is the lungs. In our study, we aimed to determine the ratios of lung metastases in patients with differentiated thyroid carcinoma and response to radioiodine therapy. MATERIAL AND METHODS: A total of 542 patients with differentiated thyroid carcinoma who were admitted to our clinic were included in the study. High doses of (131)I were administered to the patients with lung metastases. Response to therapy were evaluated with (131)I scans and stimulated serum Tg levels were examined at least 6 months after therapy. RESULTS: Lung metastases were detected in 17 (3.1%) of 542 patients with differentiated thyroid carcinoma. Of these patients to whom high doses of (131)I therapy were administered, complete response to therapy was obtained in 5 (29.4%), partial response was obtained in 3 (17.6%) and no response could be obtained in 9 (53%) patients. CONCLUSION: Although lung metastases from differentiated thyroid carcinomas are rare, those are more common in advanced ages and in males. High doses of (131)I therapy may be partially beneficial in these patients. Thus repetition of therapy is frequently required.