gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

18FDG-PET as a Marker for Prognosis in Differentiated Thyroid Cancer

Meeting Abstract

  • corresponding author presenting/speaker Christian Menzel - Klinik für MKG-Chirurgie, Uniklinik Frankfurt
  • Natascha Döbert - Klinik für Nuklearmedizin, Uniklinik Frankfurt
  • Adorjan Kovacs - Klinik für MKG-Chirurgie, Uniklinik Frankfurt
  • Konstantin Zaplatnikov - Klinik für Nuklearmedizin, Uniklinik Frankfurt
  • Michaela Welsch - Klinik für Nuklearmedizin, Uniklinik Frankfurt
  • Frank Grünwald - Klinik für Nuklearmedizin, Uniklinik Frankfurt

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocPO250

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Veröffentlicht: 20. März 2006

© 2006 Menzel et al.
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Aim: To evaluate the prognostic impact of FDG uptake in metastases of differentiated cancer of the thyroid follicle (DTC).

Methods: At the time of the second routine radioiodine therapy for standard treatment of thyroid cancer a FDG PET scan was done in 69 patients. This was a mean of six months after the initial diagnosis which was followed by thyroidectomy / lymph node dissection and a first ablative radioiodine therapy. Based on the results of the PET scan and the posttherapeutic whole body scintigraphy using 131iodine (WBS) the patients were divided into four groups: A (39 pats.) normal findings in PET and WBS, B (6 pats.) normal PET buttumor detetcted inWBS, C (14 pats.) PET and WBS showing tumors sites and D (10 pats.) only PET with detection of tumor and WBS negative.

Results: Within the four groups nosignificant differences were found ragarding age, gender and tumor-stage or -grade. Groups C and D, however, showed a tendency towards larger primaries of less well differentiation. During the further follow-up (mean 35 months) a complete remission (CR)- defined as negative WBS and PET and normal thyreoglobuline (hTG, < 1ng/ml) was achieved in 98 % of group A and 66% of group B. In patients with mixed uptake of FDG and radioiodine (C) and those with FDG uptake only (D) CR was rarely achieved. In group C a CR was found in 29% and in group D in 10% only. These findings did not correlate with the levels of stimulated hTG at the time of the second radioiodine therapy.

Conclusions: In DTC the tumor uptake of FDG seems to be an independent biological parameter of prognostic relevance. PET positive lesions seem to respond less well to convetional treatment with repetitive radioiodine and CR is rarely achieved in these cases. This holds true for lesions with sole FDG uptake (131I negative) and those with uptake of both radiopharmaceuticals. A PET scan with FDG is thus an important tool for an early estimate of potential non-responders to standard therapy protocols. These patients may need an intensified approach in order to achieve a CR.