Positron emission tomography/computed tomography in patients treated for differentiated thyroid carcinomas

Area of Science:

• Nuclear Medicine
• Oncology
• Radiology

Background:

• Differentiated thyroid cancer (DTC) has a good prognosis, but recurrence affects 20% of patients.
• Recurrent DTC can be fatal, necessitating sensitive detection and management strategies.
• Current imaging like ultrasound and iodine scans have limitations in detecting dedifferentiated or distant disease.

Purpose of the Study:

• To review the utility and limitations of PET/CT techniques in managing DTC.
• To offer practical recommendations for utilizing PET/CT in DTC patient care.
• To highlight advanced PET/CT applications for improved tumor detection and treatment selection.

Main Methods:

• Review of current literature on PET/CT applications in DTC.
• Comparison of fluorine-18 fluorodeoxyglucose (FDG) PET/CT and iodine-124 (I-124) PET/CT efficacy.
• Evaluation of PET/CT's role in identifying residual/recurrent disease and guiding therapy.

Main Results:

• FDG-PET/CT enhances detection and localization of DTC tumor foci, especially dedifferentiated types.
• I-124 PET/CT demonstrates superior performance compared to diagnostic I-131 scans and predicts treatment response.
• PET/CT aids in selecting patients for 131I therapy and identifying those at high risk of mortality.

Conclusions:

• PET/CT techniques, particularly FDG-PET/CT and I-124 PET/CT, are valuable tools in DTC management.
• These advanced imaging modalities improve diagnostic accuracy and personalize treatment strategies.
• PET/CT facilitates better patient selection for therapy and risk stratification, potentially improving outcomes.