Presentation on theme: "Preoperative PET-CT in papillary thyroid cancer Chung-Ang University, Korea Department of Surgery Byung Seup Kim, Ju Won Seok, Han suk Ryu, Kyung Ho Kang,"— Presentation transcript:
Preoperative PET-CT in papillary thyroid cancer Chung-Ang University, Korea Department of Surgery Byung Seup Kim, Ju Won Seok, Han suk Ryu, Kyung Ho Kang, Sung Jun Park, Bo Youn Cho
Introduction PET – CT 2-[fluorine-18]fluoro-2-deoxy- glucose FDG
Introduction Meaning of FDG -uptake Rate of uptake of FDG is proportional to metabolic activity An introduction to PET-CT imaging. Radigraphics 2004; 523-543 Uptake of FDG Metabolic activity
Introduction About Primary lesion We evaluated the FDG uptake of papillary thyroid cancer in preoperative PET CT.
Method FNAB : Papillary thyroid cancer Preoperative PET- CT Operation Period : 2011.3.1 ~ 2012. 2. 29 PTC was preoperatively confirmed by FANB CND was routinely performed. Preoperative PET CT was performed when patient argeed it Enrolled patients : 194
Divided into PET negative(-) and positive(+) group Negative ; Absence of FDG uptatke Postive ; Presence of FDG uptake V S. Method Backgroud : surrounding thyroid tissue
Method 1. Analyze the cliniopathologic factors related to PET (+) 2..Analyze quantity of SUVmax value according to clinicopathologic factors SUVmax : maximal standardized uptake value SUVmax of PET negative patient = SUV of surrounding thyroid tissue
Results PET sensitivity ① Primary tumor : 71.7% (138/194 patients) ② Central lymph node metz. : 4.3% (3/70 patients) ③ Lateral lymph node metz. : 62.5% (15/24 patients) False positive : 1.1%
Non-follicular variant and clinicopathologic factors by mulivariate analysis Variable Hazard ratio (95% CI)P value Extrathyroidal extensionAbsence1 (reference)0.092 Presence2.690 (0.851 - 8.502) Lymph node metastasisAbsence1 (reference) 0.141 Presence1.964 (0.800 – 4.820) SUVmax of primary lesion< 2.01 (reference)<0.001 ≥ 2.05.044 (2.111 –12.056)
Conclusion The usefulness of preoperative PET-CT for PTC was not yet certain. PET positive results and SUVmax had no relation to significant clinical factors such as extrathyroidal extension and lymph node metastasis. PET negative results or low SUVmax indicate the possibility of follicular variant subtype in papillar thyroid cancer.